Case study interpretation—Houston: Case 1

✍ Scribed by Friederike Kreisel

• Book ID: 102136629
• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 166 KB
• Volume: 80B
• Category: Article
• ISSN: 1552-4949
• DOI: 10.1002/cyto.b.20597

✦ Synopsis

CASE HISTORY

This patient is a 54-year-old man who was referred to the hematology/oncology service with a recent onset of fevers, cervical lymphadenopathy, absolute lymphocytosis, and mild splenomegaly. His past medical history was significant for seizures, which had been well controlled on Dilantin for the past 8 years. Laboratory data were significant for a mildly increased WBC of 11.9 K/cumm (normal: 4.5-11) showing absolute lymphocytosis (Fig. 1), a thrombocytopenia of 104 K/cumm (normal: 140-400), increased liver function tests of alanine transaminase of 64 IntUnits/L (normal: 17-63) and aspartate transaminase of 65 (normal: 15-41), and an erythrocyte sedimentation rate (ESR) of 14 mm/h (normal: 0-10). The phenytoin level was 5.8 mcg/mL (therapeutic range: 10-20). Peripheral blood was sent for flow cytometric analysis to assess the absolute lymphocytosis.