Table 1

List of laboratory data and imaging

CBC↓Haemoglobin, 6.7 g/dL (normal range, 13–17 g/dL)
Normal MCV, 91.0 fL (normal range, 83–100 fL)
↑ RDW, 18.3% (normal range, 11%–14%)
↓ Platelet, 6×103/µL (normal range, 150–410×103/µL)
↑ WBC, 14 600×103/µL (normal range, 4.5–11×103/µL)
Haemolysis workup↑ Total bilirubin, 48.0 µmol/L (normal range, 0–20 µmol/L)
↑ Indirect bilirubin, 26.6 µmol/L (normal range, 0–8.6 µmol/L)
↑ LDH, 1600 U/L (normal range, 125–220 U/L)
↓ Haptoglobin, 0.2 g/L (normal range, 0.3–2.0 g/L)
↑ Reticulocyte count, 34.4% (normal range, 0.3%–1.5%)
Negative direct Coombs test
Renal function and urinalysisNormal BUN, 6.7 mmol/L (normal range, 2.5–7.5 mmol/L)
Normal creatinine, 77 µmol/L (normal range, 50–110 µmol/L)
Normal urinalysis
Serology↑ CRP, 7.68 mg/L (normal range, 0.0009–3.3 mg/L)
ESR, 2 mm/1st hour (normal range, 0–10 mm/1st hour)
Negative ANA and anti-dsDNA
Negative anticardiolipin, β−2 glycoprotein I antibody and lupus anticoagulant
Negative ANCA screening
Negative anti-Smith
Normal C3 and C4
Negative rheumatoid factor and anti-CCP
Negative thyroglobulin antibody
ADAMTS 13Not available
CoagulationNormal PT, INR, PTT and fibrinogen level
↑ D-dimer, 7.29 µg/mL (normal range, <0.5 µg/mL)
Infection workup↑ Ferritin, 1556 ng/mL (normal range, 18–270 ng/mL)
Negative blood culture, urine culture, anti-HIV, anti-HBV and anti-HCV
Malignancy workupNormal range of B-HCG, CEA, CA 19-9 and tPSA
  • Chest X-ray: normal (figure 6)

  • CT of the chest, abdomen and pelvis: thickening of the abdominal aorta and iliac arteries, which is concerning of vasculitis or atherosclerosis. For chest, normal lungs and no PE (figure 7)

  • CT of the brain: normal study and no evidence of bleeding or ischaemia (figure 3)

  • ANA, antinuclear antibodies; ANCA, antineutrophil cytoplasmic antibodies; B-HCG, beta human chorionic gonadotropin; BUN, blood urea nitrogen; CA 19-9, cancer antigen 19-9; CBC, complete blood count; CCP, cyclic citrullinated peptide; CEA, carcinoembryonic antigen; CRP, C reactive protein; dsDNA, double-stranded DNA; ESR, erythrocyte sedimentation rate; HBV, hepatitis B virus; HCV, hepatitis C virus; INR, international normalised ratio; LDH, lactate dehydrogenase; MCV, mean corpuscular volume; PE, pulmonary embolism; PT, prothrombin time; PTT, partial thromboplastin time; RDW, red cell distribution width; tPSA, total prostate-specific antigen; WBC, white blood cell.