The Most Interesting Medical Cases in Hematology

Hematologists and other healthcare professionals regularly share new and fascinating cases to Figure 1. Here are five of the most interesting medical cases in hematology causing buzz in the community.

#5.

This blood smear shows, according to Figure 1 members, “a fantastic example” of auer rods present in a patient diagnosed with acute promyelocytic leukemia (APL). 

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#4.

The fourth most interesting hematology-related medical case shows a pseudo tumor in a patient with hemophilia. According to the Figure 1 member who shared the case, the patient did not receive regular factor therapy for their hemophilia, which caused “repeated bleeding in the area”. Repeated bleeding in the muscle eventually led to bone issues and the patient’s leg was amputated.

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#3.

A patient with Von Willebrand disease sustained this injury from a dirt biking accident. Several Figure 1 members warned that a reduction was needed immediately: “I would reduce the fracture ASAP and apply light dressing and refer to a foot and ankle specialist for delayed repair of syndesmotic injury. During acute phase, watch out for compartment syndrome,” a podiatrist offered. Another podiatrist cautioned, “Closed reduction in the ED may not even work, this is pretty unstable. If unsuccessful, needs to go to the OR to put on a delta frame.”

See the patient’s X-ray

#2.

In this case, we see the clubbed fingers of a patient with sickle cell disease. One study deemed clubbed fingers part of the “mortal quintet of the [sickle cell diseases] that may indicate shortened survival in such patients”.

Several Figure 1 members commented that this was one of the most extreme examples of clubbed fingers they’d seen. 

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#1.

In the most interesting hematology medical case, an internal medicine physician shared the case details of a 15-year-old patient with a longstanding history of anemia requiring several blood transfusions. The patient’s younger sibling also has anemia. Additional details included:

  • Jaundice
  • Dysmorphic features
  • Gray hair
  • Small palpebral fissure
  • Leukoplakia
  • Normal IQ and developmental milestones
  • Hepatosplenomegaly
  • Ectopic kidney
  • Normochromic normocytic with normal to high MCV
  • Hemoglobin electrophoresis with slightly raised fetal Hb
  • Negative Coomb’s test
  • Slightly raised retic count
  • Indirect hyperbilirubinemia
  • Normal liver enzymes

Several Figure 1 members chimed in with differentials, including Fanconi syndrome, Diamond-Blackfan anemia, hemolytic anemia, and sickle cell disease.

What’s your suspected diagnosis?

Published February 5, 2023


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