This week’s Morphology Monday case features a 35 year old male who presented with fatigue, pallor, easy bruising, reduced urine output, and abdominal pain following a recent gastrointestinal illness.

The blood results showed anaemia (Hb 113 g/L), severe thrombocytopaenia (Plt 16 ×10⁹/L), and normal white cell count. Biochemistry revealed raised creatinine (257 μmol/L), hyperbilirubinaemia (49 μmol/L), and mildly elevated ALT (77 U/L), with low calcium and phosphate.

The blood film showed red cell fragmentation with schistocytes and occasional microspherocytes. ADAMTS13 activity was normal, helping to exclude thrombotic thrombocytopaenic purpura (TTP).

Taken together, the clinical presentation, laboratory findings, and blood film appearances are consistent with a diagnosis of Haemolytic Uraemic Syndrome (HUS).