Sickle cell disease symptoms

55y male presented with H/o Chronic anemia since childhood and purulent non healing ulcers on both lower limbs since 2-3years. K/c/o HCV +ve not on any medications. He says that he had repeated blood transfusions for anemia. Also he had fracture of left shoulder recently. O/e CVS/RS NAD. Per abdomen: Palpable mass+ LUQ extending upto LLQ and umbilicus. Kindly go through report and give ur D/D.

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Appears to be sickle cell disease Pancytopenia could be due to splenic sequestration of cells. HCV positivity may be another factor for cytopenia. Leg ulcers is a complication of sickle cell disease. Peripheral smear findings mention nRBCs pointing to hemolytic Anemia with elevated LDH and diminished haptoglobin. Pbs Should be screened for sickles rbcs Adv Sickling test , HPLC for Hb variants. Bone marrow study SOS to rule out hematological /marrow infiltrative disorder.
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It appears to be a case of hemolytic disordee probably sickle cell disease.Pancytopenia generally hsppens because of sequestration.This leg ulcer might be a conplication of the disease.
First dx is SCD...go for hplc....second dx it could be of primary myelofibrosis...jak2 617f mutation..bm aspirate is inadequate,what about bm biopsy....
May be sickle cell disease, better to know history of any crisis. Do sickling test. Hematological malignancy should be ruled out
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Agree with dr potdar sir.. Sickle cell disease with chronic leg ulcer.
Agreed with Dr.Neelkanth Potdar Sir .
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Livedoid vasculopaty
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