Labs

The following is the complete blood count (CBC) at the time of admission:

What’s what: WBC, white blood cell count; Hb, hemoglobin; MCV, mean cell volume; MCHC, mean cellular hemoglobin concentration; RDW-SD, red cell distribution width-standard deviation; platelets, PLT; Normal values: WBC 5-10 x 10⁹/L, RBC 4-6 x 10¹²/L, Hb 12-16 g/dL, Hct 35-47%, MCV 80-100 fL, MCHC 32-36 g/dL, RDW-SD < 45 fL, platelets (PLT) 150-450 x 10⁹/L

How would you describe the CBC?

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Normocytic, normochromic anemia

What’s what: PT, prothrombin time; INR, international ratio; aPTT, activated partial thromboplastin time; Normal values: PT 9.4-12.5 seconds, aPTT 25-36.5 seconds

Other labs on day of admission:

CTA chest:

CT abdomen and pelvis:

Hematology:

Interventional radiology:

Anticoagulation resumed

Lovenox 60 mg twice daily Once her RP hematomas and her Hgb
remained stable

Proteinuria found

increase in creatinine with new proteinuria

The team has initiated methylprednisone today and we
support this decision given potential critical diagnosis

Rheumatology

RNP – positive

SSA – positive

SS-B – negative

SM (Smith) antibody – negative

4 years later: