Haemoglobin | 148 g/L (135–180) |
White cell count | 7.0×109/ L (4–11) |
Platelets | 14×109/ L (150–400) |
Internationalised normalised ratio | 1.2 |
D-dimer | 62 342 ng/mL |
Creatinine | 125 μmol/L (62–106) |
Estimated glomerular filtration rate (e-GFR) | 58 mL/min |
Adjusted calcium | 2.34 mmol/L (2.2–2.6) |
Phosphate | 1.09 mmol/L (0.8–1.5) |
Potassium | 4.2 mmol/L (3.5–5.3) |
Fibrinogen assay | 2.12 g/L (2.0–6.0) |
C reactive protein | 30 mg/L |
Lactate dehydrogenase (LDH) | 291 IU/L (135–225) |
C3 | 1.77 g/L (0.9–1.8) |
C4 | 0.50 g/L (0.1–0.4) |
COVID-19 PCR | Negative |
Cyclic citrullinated peptide (CCP) antibodies | Negative |
Antinuclear antibodies | Negative |
Double-stranded deoxyribonucleic acid (dsDNA) antibodies | Negative |
Anti-neutrophil cytoplasm (ANCA) antibodies | Negative |
Immunoglobulins (IgG, IgA and IgM) | Normal range |
B12, folate and ferritin | Normal range |
Homocysteine | Normal range |
Paroxysmal nocturnal haemoglobinuria (PNH) | No evidence of PNH clone |
Serum protein electrophoresis | Trace monoclonal band in gamma region |
ELISA for heparin-induced thrombocytopaenia (HIT) | Positive inhibitory IgG: optical density 2.453 (>0.400 indicates positive result) |
Thrombophilia screen and antiphospholipid screen were not completed, but |
Anticardiolipin antibodies | Negative – 6 u/mL (0–10) |
Beta-2-glycoprotein-1 IgG antibodies | Negative – 1.4 U/mL (0–7) |
Dil Russell viper venom time | 53.0 s (29-51) |
Lupus-sensitive APTT | 28 s (25-41) |
Blood film | Left shifted myeloid cells with metamyelocytes and myelocytes seen. True thrombocytopaenia with very occasional giant platelet. |
Bone marrow histology | Particulate and hypercellular trails. Trilineage haemopoiesis seen with maturation and no dysplastic features. A reactive marrow with eosinophils, macrophages and plasma cells seen. No abnormal infiltrate seen. Plentiful megakaryocytes with normal morphology. |
Bone marrow immunophenotyping | There is no excess of blasts at 3.2% of total cells by flow cytometry; myeloid series is left-shifted, no apparent infiltrates; 88% of total cells are CD13+CD33+myeloid: 65% CD11b+, 4% CD14+. There is no excess of myeloid blasts, 3.2% CD34+CD117+CD45int+.There are 1.2% CD19+ B cells and 7.6% CD3+ T cells; these appear polyclonal. |
Cytogenetic analysis of blood | Negative for the missense variant c.1849G>T p.(Val617Phe) (aka JAK2 V617F) in the JAK2 gene. No evidence of a clinically significant variant in targeted regions of JAK2, CALR and MPL. |
Urine cytology | Reactive/degenerate urothelial cells and contaminating squames, no malignant cells |
Ultrasound of the urinary tract | No significant findings, no obstruction |
Chest X-ray | Clear |