#TeamHaem correctly identified the main abnormalities in the film:

• Tear drop poikilocytes
• Leucoerythroblastic features (left shifted granulocytes and nucleated red cells)

The patient had splenomegaly and was suffering from weight loss and subjective fevers.

Questions:

• Name three possible causes of the blood film features
• Taking into account the clinical information what is the likely diagnosis and what tests can be done to confirm?

Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please join in the debate and learn about haematological problems along the way. The case will continue to  evolve over the coming days so keep checking #TeamHaem on Twitter for more information.

Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.

TeamHaem are not a position of authority.  It is an educational platform to allow discussion and learning.