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A S LJ-year-old male patien t is being evaluated for a lung mass seen on a CT scan for chest pain. He is otherwise healthy and his physical exam is normal. Complete blood count shows leukocyte count 5 . 700/jl.l. hemoglobin 1 LJ .2 g/d l. and platelet count 2 89.000/jl.L. The peripheral blood smear is shown below.
Based on the patient's history and peripheral blood smear, which of the following statements is most likely?
- Hereditary elliptocytosis, which is most commonly inherited as an autosomal dominant condition
- Hereditary spherocytosis, which is most commonly inherited as an autosomal recessive condition
- Hereditary elliptocytosis, which is most commonly inherited as an autosomal recessive condition
- Hereditary pyropoikilocytosis, which is most commonly inherited as an autosomal recessive condition
Medicine
A. The blood smear shows that the majority of RBCs are biconcave elliptocytes consistent nwith a diagnosis of hereditary elliptocytosis (HE). HE is usually an autosomal dominant disorder and is most commonly asymptomatic. Elliptocytes may be found in iron deficiency, megaloblastic anemia, thalassemia, myelodysplasia, and myelofibrosis. However, in contrast to HE, the percentage of ellipto-cytes in these disorders does not usually exceed 40% to 50%.
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