Hemolysis Case 2
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After ruling out spurious causes, what is the first branchpoint in the differential diagnosis of macrocytic anemia?
Click for AnswerThe reticulocyte count is appropriate (absolute count > 120 x 109/L). When considering the rest of the labs, which is most likely diagnosis (the patient was NOT on an anticoagulant):
a
Thrombotic thrombocytopenia purpura
b
Valve hemolysis
c
Sickle cell disease
d
Wilson’s disease
The elevated DIRECT bilirubin and INR point to liver disease.
e
Babesiosis
If this were Wilson’s disease what serum lab value(s) would you expect to be low?
a
Haptoglobin
b
Ceruloplasmin
c
Copper
d
Ferritin
The following were the patient’s serum ceruloplasmin and liver copper levels at time of presentation:




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