Contributed by Daniel D. Rhoads, MD, Sarah Harm, MD, Lirong Qu, MD, PhD
An 81 year-old female presented to the emergency department with complaints of blood in her urine and stool for 1 day and new onset of weakness. She has a history of congestive heart failure, type 2 diabetes, and nonalcoholic steatohepatitis. She had a cough one week ago. At presentation she appeared jaundiced. The patient had no recent blood transfusions. Relevant laboratory values (Table 1) and blood bank test results (Table 2) are reported below.
Table 1. Laboratory Values
*All samples sent to clinical chemistry were noted to contain hemolysis and/or icteric serum.
Table 2. Transfusion Medicine Testing using Gel Microcolumn Assays