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Updated information and services can be found at: http://bloodjournal.hematologylibrary.org/content/119/4/910.full.html Articles on similar topics can be found in the following Blood collections Blood Work (120 articles) Phagocytes, Granulocytes, and Myelopoiesis (280 articles) Information about reproducing this article in parts or in its entirety may be found online at: http://bloodjournal.hematologylibrary.org/site/misc/rights.xhtml#repub_requests Information about ordering reprints may be found online at: http://bloodjournal.hematologylibrary.org/site/misc/rights.xhtml#reprints Information about subscriptions and ASH membership may be found online at: http://bloodjournal.hematologylibrary.org/site/subscriptions/index.xhtml
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blood work
IMAGES IN
HEMATOLOGY
Emilie Klein and Emily Ronez, APHP, Centre Hospitalier Universitaire Lariboisiere, Paris, France
46-year-old with hepatitis C virus chronic infection was A vomiting aftermantrip10 stable HIV and white bloodsignicant physical ndings.seen for unexplained fever, headache, and a to Cameroon. There were no Complete blood count showed marked /L) and normal cell count and hemoglobin. thrombocytopenia (28
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Examination of the peripheral blood smear showed severe Plasmodium falciparum infection (parasitemia 1% and 1 schizont). In addition, there were numerous examples of hemophagocytosis on the peripheral blood smear. The top left panel shows a monocyte with particulate debris, perhaps remnants of the malarial infection. The top right panel shows a red cell engulfed by a monocyte. On the bottom left, the phagocytosed material resembles a platelet, and on the bottom right is a larger, circular, phagocytosed object that may represent an erythroblast nucleus or a giant platelet. Additional laboratory tests included triglycerides 5.29mM, ferritin 897 g/L, and lactic dehydrogenase 278 UI/L, adding support for the hemophagocytic syndrome. After receiving intravenous quinine, he rapidly improved with correction of thrombocytopenia. Hemophagocytic syndrome is a life-threatening disease associated with excessive stimulation of tissue macrophages. It has been noted in lymphoma, infections, or autoimmune diseases. Hemophagocytic syndrome with malaria infection has been described but without the demonstration of hemophagocytosis in the peripheral blood.
Many Blood Work images are provided by the ASH IMAGE BANK, a reference and teaching tool that is continually updated with new atlas images and images of case studies. For more information or to contribute to the Image Bank, visit http://imagebank.hematology.org.
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