Results of the initial investigations:
FBC 105 g/l
Platelet count 70 x10*9
MCV 82 FL
Neutrophil 1.0 x10*9/l
Large unstained cells 0.8×10*9
Small section of blood film shown above!
GGT – 98 (0-45U/L)
ALP – 56 (30-120 U/L)
ALT 65 (0-45U/L)
Ca – 2.4 (2.2-2.6mmol/L)
autoimmune screen and viral serology will take a few more days!
USS (organised quicker than CT) confirms splenomegaly – spleen measures 18x10x7cm with a normal architecture.
What are your thoughts now? further investigations? referrals to other team?
What cautions should you take with this patient?