Case 131 – the beginning

It is 9 am and you’re the liaison haematology registrar. Having just finished your coffee, the A+E registrar calls you for some advice about a 42-year-old male with an abnormal full blood count (see below) who presented with shortness of breath. He was also noted to have small bruises on his arms.

Full blood count
Hb 54               (130-180)
MCV 92            (80-100)
Platelets 12     (150-450)
WCC 3.2           (4.0-11.0)
Lymph 0.5      (0.5-3.5)
Neut 1.2          (2.0-8.0)
Eosin 0.0         (0.1-0.5)
Baso 0.0          (0.0-0.1)
Mono 0.1        (0.2-1.2)

What other information would be helpful?

What investigations would you recommend/request?

What immediate advice would you give the A+E registrar regarding the management of this patient?


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