Acanthocytic PBS
I was called to see this patient for anemia. The anemia was complicating the treatment of heart failure. The anemia was accompanied by mild, borderline thrombocytopenia and leukopenia.
The history was limited by language barriers. Physical exam suggested some cachexia. A CT scan showed nodularity of the liver.
Examination of the peripheral smear ( photograph above) revealed the misshapen cells seen. This observation led to investigation of the patient's lipid profile. He was found to have an extraordinarily low LDL level, consistent with abetalipoproteinemia.
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