This Case Wears Me Out: An Athlete With An Unusual Cause Of Exercise Intolerance - Page #3
 

Lab Studies:
WBC: 4.9
Hgb: 6.7
Hct: 19.4
Platelets: 11,000
MCV: 104
DIFF: neutrophils 80%, lymphocytes 7%, otherwise normal
RBC morphology: slight teardrop cells, polychromasia, schistocytes
CMP normal except total bilirubin: 4.1
Reticulocyte count: 17.0%
Absolute reticulocyte count: 320
D-dimer: 0.23
CK: 94
LDH: 495
ESR: 37
ANA, anti-DNA Ab, viral hepatitis panel, HIV, Monospot all negative
Direct Coombs test: positive

Other Studies:
CT chest/abdomen/pelvis showed mild splenomegaly, no lytic or sclerotic bone lesions; no enlarged lymph nodes were seen.
Bone marrow biopsy demonstrated mixed marrow elements with no evidence of increased blasts or abnormal lymphoid populations.

Consultations:
Hematology

Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.


NOTE: For more information, please contact the AMSSM, 11639 Earnshaw, Overland Park, KS 66210, (913) 327-1415.
 

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