Bone Marrow done on 20th april, 2018.  
 
Patient:Aijoni saikia  
UHID -- 78365, 20/04/18  
Male or Female: female  
 
Age: 35 yrs  
 
Clinical information:  
severe anaemia, HB 2.9gm/dl, pcv 8.1%, TC 4470/-, DLC- P-55%, L38%, M-04%,E- 01%, PLT- 1.1L/Cumm, MCV- 117.4 fl, MCH- 42pg, MCHC-359gm/l, RBC- 0.69millions/cumm  
PBs shows severe hypochromia, anisocytosis, poikilocytosis, macrocytes,polychromatic RBCs. WBC series appears normal in morphology. Pl. less than adequeate. No immature cells seen.  
Question: Bone marrow study had been done after 1 unit of blood, total 7 units blood given, still after 20 days HB has come down to 4.6 on 09/05/18.

tzankov 2018-09-03 08:38

I see profound morphologic changes in th erythroid lineage, reflecting an increased erythrocyte consumption (autoimmmune, hemaopahgocytosis, infectious?) or very severe substrate deficiency. in addition there is visible hemophagocytosis, which may be linked to the previous transfucion, but may alo be linked to genuine lymphohistiocytic hemophagocytosis. does the patient suffer form fever, organomegaly, hypetrigylceridemina, hypofibrinogenemia? have folic acid and vitamin B12 been chekced for?