Case 63 – update 2

Our four year old has been having fever and is pale. A blood count showed:

  • Hb 45g/l (115-145g/l)
  • MCV 85fL
  • WCC 12×10*9/l (5-15×10*9/l) with normal white cell differential
  • Platelets 352×10*9/l (150-450×10*9/L)
  • Reticulocytes 5×10*9/l (50-100×10*9/l)

 

A blood film is requested and here is a small part

 

Case 63 film

 

Questions:

  • What do you see in the blood film?
  • What does the low reticulocyte count mean?
  • What tests would you request next?

 

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 week so keep checking #TeamHaem on Twitter for more information.

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