Thanks for all of the responses to our blood film. We agree with the comments via #teamhaem
- Sickle cells (more on other parts of the film!)
- Howell Jolly bodies
- Target cells
- Portuguese Man O’ War (!) (not sure Prof Bain would approve of this terminology for a squashed white cell!)
The patient, who out of area, had attended the emergency department with shortness of breath and chest pain. The blood count was Hb 68g/L, MCV 85fL, WCC 15×10*9/L with neuts 12.2×10*9/L, PLT 560×10*9/L. The patient was diagnosed with a sickle cell chest crisis. Hyposplenism causing Howell Jolly bodies is common in sickling disorders. High performance liquid chromatography and Sickledex confirmed HbSS (homozygous sickle cell anaemia). It would be important to inform the transfusion lab of the admission as a full red cell antigen phenotype should be performed prior to any transfusion.
More pictures later!