A 5-year-old white boy was admitted with a fractured tibia following a playground accident. A CBC was ordered on admission.
|Hemoglobin||10.2 g/dL||11.5-13.5 g/dL|
|RBC||3.6 x 1012/L||3.9-5.3 x 1012/L|
|WBC||12.5 x 109/L||4.5-13.5 x 109/L|
|MCV||96.4 fL||75-87 fL|
|MCH||28.3 pg||24-30 pg|
|MCHC||38 %||31-36 %|
The peripheral blood smear revealed anisocytosis, polychromasia, and numerous RBCs that appeared small and dense when compared to normal RBCs in the same field. Follow up testing included serum bilirubin, haptoglobin, and a DAT. The bilirubin was slightly increased, the haptoglobin was normal, and the DAT was negative.
What are the small, dense erythrocytes? (What abnormal morphology is present in the peripheral blood of this patient?)
What is the most likely diagnosis for this patient?
What testing should we perform to make the diagnosis? How it performed and what are the expected results?
What is the appropriate treatment for this patient?