Answer to CBC Case Study

The CBC shows microcytic erythrocytosis (without polycythemia) and thrombocytopenia.
Microcytic erythrocytosis suggests either:
- 1. Thalassemia minor/trait
- 2. PV with iron deficiency
How can we tie together the microcytic erythrocytosis and thrombocytopenia?
- Thal minor is not associated with splenomegaly, hypersplenism and thrombocytopenia.
- PV with iron deficiency could be associated with portal vein thrombosis and secondary hypersplenism.
Sometimes, we have to abandon Occam’s razor and consider the presence of multiple conditions (Hickam’s dictum: “A man can have as many diseases as he damn well pleases”).
In this case, the patient was a 27 y.o. M with beta thalassemia trait (with excellent compensation, i.e., normal Hb) and ITP