Author(s): Suhanyah Mahathevan
A 69-year-antique man changed into admitted following a fall. On admission the white cellular rely was 12,920/μL, hemoglobin 83 g/L and the platelet remember 1,550,000/μL (150,000-450,000). Serum sodium, potassium and chloride were respectively 141, 5.8 (three.5-5.1) and 113 mmol/L respectively. Plasma sodium, potassium and chloride (on a sample gathered into lithium heparin at the identical time) had been 141, 4.three and 112 mmol/L, respectively. Serum creatinine become 1.five mg/dL (0.8-1.three). The blood image showed macrocytes and spherocytes with normal leucocytes, collectively with extreme thrombocytosis. Bone marrow turned into normocellular and had extended megakaryocytes with a few dysplastic forms. Platelet lakes/clumps have been prominent. The myeloid series changed into everyday and the erythroid series had reduced precursors. The trephine biopsy showed increased megakaryocytes with clustering, without full-size fibrosis. JAK2 V617F mutation was detected. The affected person changed into diagnosed to have vital thrombocythemia.
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