Hemoglobin E disease, erythroblastopenia
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2010, Vol 27, Issue 6
Abstract
An 18-year-old woman presented to the outpatient clinic because of fever, chills, malaise and symptoms from the upper respiratory and gastrointestinal tract. Five days before her admission she had sore throat, cough and fever up to 38 °C. She was treated with amoxicillin without any improvement. Subsequently, abdominal pain with vomiting and diarrhea, weakness and dyspnea on slight exertion were added; fever was up to 39 °C, and thus the patient came to the hospital. Her past medical history was unremarkable. Physical examination on admission revealed pallor faint, maculopapular rash in the extremities, cervical and supraclavicular microlymphadenopathy (smaller than 0.5 cm in diameter, painless and mobile) and a mild non-tender splenomegaly (3 cm below costal margin). The liver was not palpable. Patient’s temperature was 38.2 °C, while her pulse rate was 98/min and the respiratory rate was 26/min. Fundoscopy and neurological examination were unremarkable. Her hematological profile was as follows: Ht 18.6%, Hb 6.5 g/dL, MCV 62 fL, MCH 21.6 pg, reticulocytes 0.1%, white blood cell counts 3.6×109/L (neutrophils 48%, lymphocytes 44%, monocytes 7%, eosinophils 1%) and platelet counts 158×109/L. The morphology of the peripheral blood smear is shown in figure 1. Serum biochemistry was as follows: urea 0.18 mg/dL, creatinine 1.2 mg/dL, total bilirubin 0.80 mg/dL, SGOT 35 IU/L, SGPT 40 IU/L, alkaline phosphatase 128 IU/L, γ-GT 25 IU/L, LDH 290 IU/L, uric acid 5.2 mg/dL and total proteins 6.1 g/dL with normal electrophoretic diagram. The bone marrow aspiration findings are shown in figure 2
Authors and Affiliations
J. MELETIS, A. SARANTOPOULOS, E. PAPAKOSTAS, T. CHATZILEONIDA, M. MICHAEL, L. PAPAGEORGIOU, N. VINIOU, K. KONSTANTOPOULOS
Keywords
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