PMC6717731_01
Peripheral blood smear with a nucleated red blood cell, polychromasia, "fragmented" RBCs and thrombocytopenia. The arrow points to a dysmorphic "fragmented" RBC (Wright 's stain, original magnification x1000).
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His peripheral blood smear was reviewed, and it showed nucleated RBCs, anisopoikilocytes, schistocytes, hypersegmented neutrophils (not captured) and very few platelets (Figure 1).
Timeline summary showing gradual improvement of ongoing hemolysis demonstrated by decreasing bilirubin and serum lactate dehydrogenase (LDH) levels.
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ADAMTS13 activity came back normal at 61% (>=60%). Accordingly, plasmapheresis was discontinued, parenteral B12 replacement was continued which resulted in cessation of hemolysis (Figure 2) and normalization of hemoglobin and platelets (Figure 3).
Timeline summary showing gradual improvement of anemia and thrombocytopenia demonstrated by increasing hemoglobin (Hb) and platelets. Two packed red blood cells were transfused on day 0 and day 4.
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ADAMTS13 activity came back normal at 61% (>=60%). Accordingly, plasmapheresis was discontinued, parenteral B12 replacement was continued which resulted in cessation of hemolysis (Figure 2) and normalization of hemoglobin and platelets (Figure 3).