Erythrocyte Disorders: Smear Case 1: Jaundice and the Peripheral Smear

Warm antibody hemolytic disease

  • A 49-year-old male with pneumonia was treated with penicillin. He became jaundiced with yellow sclera.
  • Observe the photograph of his peripheral blood smear. Anisocytosis was observed with pale-centered microcytes and polychromatophilic macrocytes.
  • Since penicillin is a classic offender for autoimmune hemolytic disease, the clinician asked for an antihuman globulin (AHG) test, also known as the Coombs test.
  • A positive AHG reaction occurs when the antibody stimulated by penicillin becomes attached to red blood cells.
  • Hemolysis follows, leaving the patient with jaundice and a peripheral blood smear, as demonstrated in the photograph.

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