Case 100 (part A) – the beginning

We’re going to do a few short cases this week… hope you’re on your toes!

You are working in a GP surgery and a 28 year old female comes to see you as she has been feeling fatigued. Further evaluation reveals she has a low mood and stresses at work and family life are contributing to this. The patient requests some ‘blood tests’ to ensure there is ‘nothing else going on’ and you agree.

The FBC returns:

  • Hb 130g/l (115-165)
  • MCV 90fl (82-98)
  • WCC 3.6×109/l (4-11)
  • Neutrophils 1.1×109/l (1.7-7.5)
  • Lymphocytes 1.8 (1.5-4.5)
  • Monocytes 0.4 (0.2-1.0)
  • Eosinophils 0.2 (0-0.5)
  • Basophils 0.1 (0-0.1)
  • Platelets 250×109/l (150-450)

You also check a ferritin, U&E, LFT and TSH all of which were within the reference range.

Questions:

  • How do you explain this abnormality to her?
  • Would you investigate this further?

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.

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.

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Online education and discussion about all things haematological
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