She has been aware of these problems for approximately 4 months. A physical exam

Question

She has been aware of these problems for approximately 4 months. A physical exam was conducted during which the PCP noted multiple rash like lesions on sun exposed areas of the body. Primarily on the arms and legs. A tissue biopsy of one of the lesions was taken and microscopic examination of the tissue reveled vasculitis. An ANA test was positive. The lungs were lcear to auscultation, heart sounds were normal with a prominent S1 and S2, and there was no evidence of enlarged lymph nodes. Blood tests revealed an HCT of 23% and RBC of 3.5 million/mm^3. She was also slightly jaundiced with some yellowing within the sclera. Microscopic examination of a peripheral blood smear revealed that red blood cells were normal in shape, size and color, ruling out iron, folate and vitamin B12 deficiencies. The total WBC count was 5,500/mm^3 and her PLT count was 350,000/mm^3. Urinalysis was normal. she was placed on prednisone for 2 months, during which time all signs and symptoms of the disease resolved. What can be said about the patients HCT, RBC count, WBC count and PLT count?

Explanation / Answer

It is given that the patient had a positive ANA (antinuclear antibody) test, and vasculitis, which indicates that the patient had the autoimmune disease, probably the systemic lupus erythematosus (multiple rashes like lesions). Patients with lupus and other autoimmune diseases are likely to have immune-mediated bone marrow failure and excessive destruction of cells in the periphery. This bone marrow failure might be the cause of reduced levels of hematocrit, red blood cell count, white blood cell count, and platelet count in the patient.

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