Morphology Monday | Case MM250818

This week’s Morphology Monday case comes from a 35 year old male who presented with:

  • Fatigue and pallor
  • Easy bruising
  • Reduced urine output
  • Mild abdominal pain following a recent gastrointestinal illness

The full blood count results showed the following:

  • Hb: 113 g/L
  • WBC: 5.46 ×10⁹/L
  • PLT: 16 ×10⁹/L

Due to the severely low PLT results a blood film was made. The images are below:

Biochemistry results:

  • Creatinine: 257 μmol/L
  • Bilirubin: 49 μmol/L
  • ALT: 77 U/L
  • Calcium: 1.84 mmol/L
  • Phosphate: 0.4 mmol/L

Other results:

  • ADAMTS13 activity: 64.7 IU/dL (within normal range)

Given the clinical presentation, the laboratory investigation results and the blood film images, what do you think is wrong with the patient?

3 Comments

  1. Severe hemolysis and fragmentocytosis favor microangiopathic fragmentation syndromes like HUS and ITP. TTP ruled out due to regular ADAMTS13 activity.

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