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A 24-year-old male presented with weakness and fever

Dr. Maruf Rumi

Phase-B resident

Dept. of Haematology

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Case summary

  • Mr. Russesl, 24 years old student, hailing from Dumki, Patuakhali presented with-
  • weakness and occasional fever for 1 month
  • weakness hampering his daily activities, not associated with SOB or palpitation and no difficulty in raising arm above shoulder or standing from sitting position

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History-

  • occasional low grade fever (not documented)
  • no h/o cough, burning micturition, joint pain
  • no bleeding manifestation
  • h/o 1 unit blood transfusion

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On examination-

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  • pt is mildly anaemic, not icteric, no rise of temperature, no bony tenderness, no lymophadenopathy
  • systemic examination reveals no abnormality

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???Diagnosis

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08/11/21

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normocytic, mormochromic with macrocytes

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reduced in number, mature

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reduced

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pancytopenia

normocytic, mormochromic

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reduced in number, mature

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reduced

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pancytopenia

Hb 8.2 g/dl

ESR 18

WBC 3.76

N 28%

L 66%

Blast 0%

PLT 40

normocytic, mormochromic

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reduced in number, mature

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reduced

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pancytopenia

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Hb 8.5 g/dl

ESR 25

WBC 3.5

N 28%

L 65%

Blast 0%

PLT 35

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PBF-

Dimorphic, MCV 101

pancytopenia

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Bilirubin (T)

Na

K

creatinine

uric acid

SGPT

SGOT

calcium

magnessium

LDH

albumin

0.7 mg/dl

140 mmol/L

4.5 mmol/L

1.0 mg/dl

4.5 mg/dl

54 U/L

120 U/L

8.5 mg/dl

1.9 mg/dl

1132 U/L

47 g/L

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PT

aPTT

fibrinogem

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Reticulocyte

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Iron

TIBC

Ferritin

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HbsAg

Hb electrophoresis

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Echocardiogram

12 sec

30 sec

213.40 mg/L

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2.50%

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35 ug/dl

374 ug/dl

8.64 ng/dl

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(-)ve

Normal

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Normal, EF 66%

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Repeat Bone marrow study-

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  • Non specific marrow findings