J Hematol

Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc

Journal website https://www.thejh.org

Case Report

Volume 11, Number 1, February 2022, pages 15-20

Leukoerythroblastosis in a Sickle Cell Patient With Pregnancy: An Interesting Peripheral Blood Smear Finding

Figure 1. Peripheral blood smear. (a-c) Smear shows presence of abnormal RBC morphology in low and high magnification: sickle cells (green arrow), target cells (blue arrow), schistocytes (*), nucleated RBCs (red arrow) along with giant platelets (*) and myeloblast (black arrow). (d-f) Smear shows presence of myelocytes (red arrow) with Howell-Jolly body (green arrow) (d). (g-i) Smear shows metamyelocytes (blue arrow). RBC: red blood cell.

**Table 1.** Complete Blood Count With Differential
	Reference range	July 20, 2020	August 24, 2020	August 30, 2020	September 18, 2020	September 27, 2020
WBC: white blood cell; RBC: red blood cell; MPV: mean platelet volume; segs: segmented neutrophils; CRP: C-reactive protein; LDH: lactate dehydrogenase; H: high; L: low.
WBC count, × 10⁹/L	4.5 - 11.0	11.3 (H)	15.9 (H)	20.4 (H)	21.8 (H)	13.2 (H)
RBC count, × 10¹²/L	3.70 - 5.50	3.55 (L)	2.70 (L)	2.54 (L)	2.60 (L)	2.36 (L)
Hemoglobin, g/dL	12.0 - 16.0	11.2 (L)	8.9 (L)	8.5 (L)	8.4 (L)	7.6 (L)
Hematocrit, %	34.0 - 46.0	33.5 (L)	27.0 (L)	25.8 (L)	25.0 (L)	22.9 (L)
Platelet count, × 10⁹/L	130 - 400	332	335	294	300	431 (H)
MPV, fL	6.8 - 10.0	8.7	10.3 (H)	9.7	9.7	8.8
Nucleated RBC/100 WBC	%WBC		35	32	9	10
Polys (segs), %		76.4	87.5	75.7	70.2	52.9
Lymphocytes, %		17.0	7.7	16.5	17.3	33.7
Monocytes, %		5.8	4.8	6.8	9.6	5.8
Eosinophils, %		0.3				2.9
Basophils, %		0.5			1.0	2.9
Metamyelocytes, %				1.0		1.0
Myelocytes, %					1.9
Sickle cells			Moderate	Slight	Slight	Occasional
D-dimer, ng/mL	0 - 230	Not performed	Not performed	Not performed	Not performed	Not performed
CRP, mg/dL	0.1 - 0.8	Not performed	Not performed	Not performed	Not performed	Not performed
LDH, U/L	90 - 200	184	Not performed	Not performed	Not performed	Not performed

Table 1. Complete Blood Count With Differential

Reference range

July 20, 2020

August 24, 2020

August 30, 2020

September 18, 2020

September 27, 2020

WBC: white blood cell; RBC: red blood cell; MPV: mean platelet volume; segs: segmented neutrophils; CRP: C-reactive protein; LDH: lactate dehydrogenase; H: high; L: low.

WBC count, × 10⁹/L

4.5 - 11.0

11.3 (H)

15.9 (H)

20.4 (H)

21.8 (H)

13.2 (H)

RBC count, × 10¹²/L

3.70 - 5.50

3.55 (L)

2.70 (L)

2.54 (L)

2.60 (L)

2.36 (L)

Hemoglobin, g/dL

12.0 - 16.0

11.2 (L)

8.9 (L)

8.5 (L)

8.4 (L)

7.6 (L)

Hematocrit, %

34.0 - 46.0

33.5 (L)

27.0 (L)

25.8 (L)

25.0 (L)

22.9 (L)

Platelet count, × 10⁹/L

130 - 400

332

335

294

300

431 (H)

MPV, fL

6.8 - 10.0

8.7

10.3 (H)

9.7

8.8

Nucleated RBC/100 WBC

%WBC

Polys (segs), %

76.4

87.5

75.7

70.2

52.9

Lymphocytes, %

17.0

7.7

16.5

17.3

33.7

Monocytes, %

5.8

4.8

6.8

9.6

5.8

Eosinophils, %

0.3

2.9

Basophils, %

0.5

1.0

2.9

Metamyelocytes, %

1.0

Myelocytes, %

1.9

Sickle cells

Moderate

Slight

Occasional

D-dimer, ng/mL

0 - 230

Not performed

CRP, mg/dL

0.1 - 0.8

Not performed

LDH, U/L

90 - 200

184

Not performed

**Table 2.** Results for SARS-CoV-2 (PCR)
	July 8, 2020	July 13, 2020	August 7, 2020	August 24, 2020	September 18, 2020
SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; PCR: polymerase chain reaction.
SARS-CoV-2	Not detected	Not detected	Detected	Detected	Not detected

Table 2. Results for SARS-CoV-2 (PCR)

July 8, 2020

July 13, 2020

August 7, 2020

August 24, 2020

September 18, 2020

SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; PCR: polymerase chain reaction.

SARS-CoV-2

Not detected

Detected

Not detected

**Table 3.** Hemoglobin Electrophoresis Results
	Reference range	August 7, 2020	August 24, 2020	August 30, 2020
H: high; L: low.
Hemoglobin A, %	95.0 - 98.0	36.5 (L)	25.1 (L)	19.5 (L)
Hemoglobin A2, %	1.9 - 3.1	3.7 (H)	4.0 (H)	4.4 (H)
Hemoglobin F, %	0.0 - < 2.0	4.9 (H)	4.8 (H)	4.5 (H)
Hemoglobin S, %	0.0 - 0.0	54.9 (H)	66.1 (H)	71.6 (H)

Table 3. Hemoglobin Electrophoresis Results

Reference range

August 7, 2020

August 24, 2020

August 30, 2020

H: high; L: low.

Hemoglobin A, %

95.0 - 98.0

36.5 (L)

25.1 (L)

19.5 (L)

Hemoglobin A2, %

1.9 - 3.1

3.7 (H)

4.0 (H)

4.4 (H)

Hemoglobin F, %

0.0 - < 2.0

4.9 (H)

4.8 (H)

4.5 (H)

Hemoglobin S, %

0.0 - 0.0

54.9 (H)

66.1 (H)

71.6 (H)