The following is the full blood count of a 66-year-old man admitted to the High Dependency Unit following a gastro-intestinal haemorrhage:

Parameter

Result

Normal Range

Haemoglobin

84 G/L*

130 – 175

White Cell Count

8.3 x 109/L

4.0 – 11.0

Platelets

240 x 109/L

150 – 450

Reticulocytes

220 x 109/L*

10 – 80

Neutrophils

5.8 x 109/L

1.8 – 7.5

Lymphocytes

1.5 x 109/L

1.5 – 4.0

Monocytes

0.4 x 109/L

0.2 – 0.8

Eosinophils

0.6 x 109/L*

0.0 – 0.4

Haematocrit

0.25*

0.4 – 0.52

MCV

88.4 fl

82 – 98

MCH

30.2 pg

27.0 – 34.0

MCHC

341 g/L

310 – 360

What is the most likely cause of this haematological profile?

 

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College Answer

Acute blood loss

Discussion

If one were obsessive, one could also point out that the slight elevation of the eosinophil count could point to eosinophilic oesophagitis- but it could just as easily be a reaction to the transfusion of blood products.

Overall, the blood results have nothing weird in them except anaemia.

References

Sgouros, Spiros N., Christina Bergele, and Apostolos Mantides. "Eosinophilic esophagitis in adults: a systematic review." European journal of gastroenterology & hepatology 18.2 (2006): 211-217.