| HU Division of Allied Health Sciences Department of Clinical Laboratory Science Sixth and Bryant St, NW Washington, D.C. 20059 (202) 806-7572 |
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| Hematology Case Studies |
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| DEPARTMENT OF CLINICAL LABORATORY SCIENCE HEMATOLOGY CASE STUDIES | ||||
| Case 1 | ||||
| Introduction A 30-old-male of Afro-American descent was treated at the Howard University hospital complaining of extreme tiredness after exercise, occasional dizziness, and shortness of breath. On one occasion he actually fainted on the job. | ||||
| Question What valuable information can be extracted from this? | ||||
| Correct Response The clinical symptoms of extreme tiredness often suggest the presence of an anemia , but there is not enough information to make an assumption of the specific anemia present. | ||||
| Initial Laboratory Profile WBC 10.0X10 9/L (4.8-19)mm3 MCV 79 fl.( 78-96) RBC 5. 0X10 12/L (4.2-5.4) MCH 24 pg (27-31) Hb 13. 9gm/ dL (12-16) MCHC 34 %(32-36) Hct 40 % (37-47) Plt 150X10 9/L (150-450) N | ||||
| Question What does the evaluation of these routine lab results show? | ||||
| Correct Response The hemoglobin(Hb), hematocrit (Hct), and the Red Cell count (RBC) are all below the acceptable reference ranges for the age and sex of the patient, but the hemoglobin is commonly used as the indicator of anemia. A reduced hemoglobin value always suggest Anemia. | ||||
| Additional Lab Results Peripheral smear morphology shows: microcytic, hypochromic erythrocytes, poikilocytosis, occasional target and banana shaped cells. The white blood cells(WBC’s) had fairly normal morphology, and the platelet distribution was slightly increased. | ||||
| Question Is this smear abnormal and which are the specific abnormalities? | ||||
| Correct Response The erythrocytes(hypochromic/ microcytic, targets . The banana shaped cells are commonly found in anemia caused by the deficiency of dietary iron. Iron Deficiency Anemia-IDA | ||||
| Question What additional testing should be done to make proper identification of the anemia? | ||||
| Correct Response The following tests are commonly used to differentiate between the microcytic, hypochromic anemia:
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Patient Test Results
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| Question What is the correct specific anemia presented here? | ||||
| Correct Response Iron Deficiency Anemia -IDA | ||||
| Discussion Iron deficiency anemia is one of the most frequently encounters anemia. This anemia may result from nutritional deficiency, abnormal absorption of iron , increased demand or excessive bone marrow loss. Among all of these nutritional deficiency appears to be the most frequent cause of Iron Deficiency Anemia (IDA). | ||||
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