Haematology
Case 11: A Patient with Increasing Fatigue and Mild Jaundice
CASE
A 53‐year‐old woman presents to her GP with a 2‐month history of gradually increasing fatigue. She does not report any other symptoms. On examination, she is rather pale and mildly jaundiced. She also has vitiligo over her hands. There is no organomegaly.
Blood tests showed:
Hb 7.9 g/dL MCV 118 fL WCC 4.5 × 109/L Platelets 140 × 109/L Bilirubin 45 µmol/L ALT 25 U/L ALP 115 U/L
Electrolytes, calcium and inflammatory markers: normal
QUESTION 1
Your score this session: 0 of 0
What is the most likely diagnosis?
Appropriate therapy is initiated. She is reviewed by her GP one month later and although she initially felt an improvement, she is still not back to normal. She is feeling tired again and slightly breathless on exertion.
Repeat blood tests show:
Hb | 7.5 g/dL |
MCV | 75 fL |
WCC | 5.5 x 109/L |
Platelets | 220 x 109/L |