Case Three

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A 50 year old man with a history of sickle cell disease presents to the urgent care clinic in August with 2 weeks of fever, fatigue, and myalgias. His labs are notable for WBC 6.0, Hb 9.2, platelets 110,000, and creatine 1.4 (baseline 1.0).

You send a smear, which shows the following.

One week later, he returns for repeat labs. His labs show the following WBC 5.0, Hb 6.8, platelets 90,000, and creatinine 1.8.

Given worsening anemia, you repeat a peripheral smear and review it with the hematopathologist.