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Ms. X is a 30-year old African American female who presented to the ED with a complaint of body aches. She reports generalized body aches and joint pains. The pain is constant, throbbing in nature and is a 10 out of 10 in severity. The pain has been ongoing for the last week and has progressively gotten worse. She was seen in the ED 5 days ago, given pain medication and discharged. She has had profuse diarrhea and fevers for the last 3 days. She denies any dyspnea, cough, abdominal pain, nausea, or vomiting. Her past medical history is significant for sickle cell anemia, iron overload. CVA 16 years ago, splenic infarction, and acute chest syndrome. Vitals 99.4 – 117 – 24 – 136/87, O2 sat is 100% on Room air. She is oriented x3. Restless. Heart rate is regular, no murmur or gallop. Lungs are clear bilaterally. Abdomen soft and nontender. No peritoneal signs. Elbows, shoulders, and knees are tender to touch bilaterally.
Lab — result
sodium 139 meq/l
potassium 5.0 meq/l
creatinine 0.47 mg/dl
total bilirubin 10 mg/dl
BUN 7 mg/dl
WBC 15,200
Hematocrit 19%
Hemoglobin 6.5 g/dl
ferritin 3155 ng/ml
CXR -is negative
I believe its hemolytic anemia due to sickle cell anemia history.
What data in the clinical scenario supports this diagnosis?Â
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