Case 100 (part B) – update

Our patient’s neutrophilia/thrombocytosis is attributed to his chest infection. You advise to get a repeat FBC in one month but he forgets and goes to Spain for some ‘winter sun’. On return he has a repeat FBC:

  • Hb 145g/l (115-165)
  • MCV 92fl (82-98)
  • WCC 28.6×109/l (4-11)
  • Neutrophils 22.1×109/l (1.7-7.5)
  • Lymphocytes 1.8 (1.5-4.5)
  • Monocytes 1.0 (0.2-1.0)
  • Eosinophils 0.9 (0-0.5)
  • Basophils 1.2 (0-0.1)
  • Platelets 500×109/l (150-450)

A blood film is performed:

Case 100 part b

Questions

  • What would you look for on examination?
  • What further test would you do?
  • What would you explain to the patient?

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