This week’s case comes from a patient of Southeast Asian descent who was recently admitted for a routine surgical workup. Interestingly, despite having no significant symptoms of anaemia, their laboratory results caught the attention of the haematology team.
These inclusions are formally known as critical green inclusions or green neutrophilic inclusions. In clinical circles, they have earned the ominous nickname “crystals of death” due to their strong association with impending mortality.
This week’s case features a patient currently in the Intensive Care Unit (ICU) suffering from acute liver failure. The laboratory data and the resulting blood film provide a sobering look at the systemic impact of hepatic collapse.
This week’s case started with a “heads-up” call from the Haematology SpR before the sample even reached the lab. The staggering WBC and the specific clinical request made for an interesting discussion.
This week’s case began with an urgent call from the haematology Specialist Registrar (SpR) before the sample had even reached the laboratory. A patient had been referred from another hospital and presented to the Emergency Department with a massive clinical picture.
Based on these findings, the diagnosis is Haemolytic Disease of the Foetus and Newborn (HDFN) caused by Rh sensitisation, following the clinical scenario where the mother did not receive anti-D prophylaxis.
This week’s case comes from the Neonatal Intensive Care Unit. A newborn has presented with early-onset jaundice and a rapidly falling haemoglobin level.
The patient is missing their spleen. In addition to the underlying HbE/β-thalassaemia, the film showed classic “post-splenectomy” features that occur when the body’s primary “quality control” filter is removed.
The blood film images are from a transfusion dependent patient who is a compound heterozygote for HbE/beta-thalassaemia.
Don’t let a nucleolus default you to “Blast”: Always assess the chromatin density.
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