BOF: 49
An 80-year-old male is admitted with a history of feeling
tired and lethargic and unable to fend for himself.
On examination he is noted to have generalised
lymphadenopathy and an enlarged spleen.
Investigations
Hb 6.8 g/dL
WBC 30 x 109 /L (94 % lymphocytes)
Platelets 55 x 109/L
Blood film shows spherocytes
Reticulocytes 10%
In this patient which one of the following would you
arrange to identify the cause of the patient’s anaemia?
a)
Osmotic fragility test
b)
Bone marrow examination
c)
Iron studies
d)
Coomb’s test
e)
Plasma protein electrophoresis
Answer: d)
The history, examination findings and the finding of a
severe lymphocytosis would indicate that the patient has chronic lymphocytic
leukaemia
A Coomb’s positive haemolytic anaemia is a known
complication of this condition and anaemia with a reticulocytosis would be in
keeping with this
Spherocytes may occur in autoimmune haemolytic anaemia
Revision Tip
Revise chronic lymphocytic leukaemia
KEYS to SUCCESS in Medicine page 402-404
Revise autoimmune haemolytic anaemia
KEYS to SUCCESS in Medicine page 384-386
