An 18-Year-Old with Pancytopenia
Description
-
The patient is a previously healthy 18-year-old female with a history of menorrhagia. She was referred for incidentally noted pancytopenia on routine blood work. At the time of referral, pancytopenia was persistent for 6 months. She has had normal CBCs in the past. She has a history of menorrhagia; however, during the past few years, her periods have become more regular and have not been heavy. Prior workup for menorrhagia, including hormone testing, did not reveal any underlying etiology.
The patient denies bleeding symptoms including epistaxis, bruising, and blood in urine or stool. She also denies fatigue, shortness of breath, dizziness, lightheadedness, visual changes, headache, and chest pain.
Laboratory Investigation and Physical Examination
- Physical exam is significant for pallor, otherwise unremarkable.
- CBC: WBC 2.7 k/mcL, Hb 7.3 g/dL, platelets 52 k/mcL, MCV 99.5 fL, ANC 600, monocytes 200
- Absolute retic count: 45.10
- Metabolic panel including liver tests, lactate dehydrogenase, and haptoglobin normal for age.
Based on the available history and lab results, which of the following diagnostic tests is most likely to reveal the diagnosis?
Jessica Briggs, DO, & Mahvish Rahim, MD
Division of Pediatric Hematology, Oncology, & Cellular Therapy
The Children's Hospital at Montefiore
Bronx, NY Associations
-
- Details
- Categories: Case Quiz