Table 1.
Initial investigations.
| Test | Date | Results |
|---|---|---|
| Complete blood count | 10 Feb 2011 | Hemoglobin 5.4 g/dL (fell to 4.5 g/dL on day 3); WBC 15; 10e9/L Neutrophils; 54% Lymph; 24% Monocytes 19%; Eosinophils 2%; Plat 719 (10e3/uL); MCV 75 fL |
| Blood film | 13 Feb 2011 | Target cells++ sickle cells++ polychromasia++, hypochromia with occasional microcytes |
| PT; PTT | 12 Feb 2011 | PT 12.5/12.3; PTT31.8/27.5 |
| ESR | 10 Feb 2011 | 128 mm/h |
| Urea and electrolytes | 11 Feb 2011 | *Na 138 (135-145 mmol/L); K 3.8 (3.5-5.0 mmol/L); Urea 1.5 (2.5-6.7 mmol/L); Creat 35 (9-124 Umol/L); Cl 111 (95-110 mmol/L); CO2 18 (20-28 mmol/L) |
| Liver function tests | 12 Feb 2011 | °Total proteins 78 g/L (68-84 g/L); Albumin 20 (38-52 g/L); Glob 58 (18-38 g/L); ALP 224 (30-120 U/L); GGT 40 (7-32 U/L); AST 101 (15-45 U/L); LDH 218 (105-200 U/L); Total bilirubin 29 Umol/L; Direct bilirubin 13 Umol/L |
| ANA | 15 Feb 2011 | Negative |
| dsDNA | 15 Feb 2011 | Not available |
| C3 | 15 Feb 2011 | *115 (90-180 mg/dL) |
| Rh factor | 15 Feb 2011 | Negative |
| C-reactive protein | 15 Feb 2011 | *1.48 (<0.5) |
| Blood and urine cultures | 11 Feb 2011 | Negative |
| Urine analysis | 10 Feb 2011 | Trace urobilinogen only |
WBC, white blood cell count; Lymph, lymphocytes; Plat, platelets; MCV, mean corpuscular volume; PT, prothrombin time; PTT, partial thromboplastin time; ESR, erythrocyte sedimentation rate; Na, sodium; K, potassium; Creat, creatinine; Cl, chloride; Glob, globulin; ALP, alkaline phosphatase; GGT, gamma-glutamyl transferase; AST, aspartate aminotransferase; LDH, lactate dehydrogenase; ANA, antinuclear antibodies.
*References from local laboratory;
°References from The Harriet Lane Handbook, 18th ed. (by Johns Hopkins Hospital). Mosby: Maryland Heights, MO; 2008.