Case 140: The beginning

You are the on call haematologist and are asked by one of the secretaries to speak to a worried GP
on the phone.

It is regarding a 52 year old lady who saw her GP with a 2 week history of worsening fatigue and
shortness of breath on minimal exertion. Her full blood count is as follows:

Hb 81 g/L
MCV 103 fL
Plt 138 x109/L
WCC 11.2 x109/L
Neut 4.8 x109/L
Lymph 5.1 x109/L
Mono 1.0 x109/L
Eosino 0.3 x109/L
Baso 0.01 x109/L

Her GP is concerned because this lady has no bleeding symptoms and her last haemoglobin done 2
months previously was in the normal range.

What advice would you give her GP?

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