This week’s Morphology Monday case comes from a 26-year-old individual with a known history of anaemia who presented to A&E with generalised fatigue, mild jaundice, and bone pain in the lower limbs. No recent infections or travel. On examination, they appeared pale and icteric with mild splenomegaly.

Their FBC results showed:

• WBC: 13.8 ×10⁹/L
• RBC: 2.95 ×10¹²/L
• Hb: 68 g/L
• HCT: 0.210
• MCV: 71 fL
• MCH: 23 pg
• RDW: 24.8%
• PLT: 453 ×10⁹/L
• Retic count: Elevated

The blood film shows marked anisopoikilocytosis with features consistent with increased red cell turnover.