Case 623 -- A 33 year old, pregnant female with neutrophilia

Contributed by Ramachandra Gullapalli, MD, PhD, Anne Shaheen MD and Lydia Contis, MD


PATIENT HISTORY

The patient is a 33 year old female who presented for a routine clinical evaluation during a twin pregnancy. The patient was asymptomatic otherwise and appeared to be in good health. The patient's gestational age was 22 weeks at clinical presentation. Routine laboratory investigation of the peripheral blood showed an absolute neutrophilia along with the following clinical laboratory values:

LABORATORY VALUES

Microscopic images of the peripheral blood smear are as follows:

MICROSCOPIC EXAMINATION

Figure 1. Peripheral blood smear (50X). Wright Giemsa stain.

Figure 2. Peripheral blood smear (100X). Arrows point towards the representative abnormal red blood cells.

Figure 3. Peripheral blood smear examination (100X). Some red blood cells demonstrate basophilic stippling of the cells (red squares around the cells); arrows point to abnormal red blood cells characteristic of the pathology.

FINAL DIAGNOSIS


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