Specimen Name Result Units Range
Blood Hb 84 g/L (130-180)
     R.B.C. 2.5 x1012/L (4.5-6.0)
     P.C.V. 0.26 L/L (0.4-0.5)
     M.C.V. 107 fL (80-98)
     M.C.H.C. 317 g/L (315-355)
     R.D.W. 13.7 % (11.5-15.5)
Platelets 11 x109/L (150-450)
     IPF 15.2 % (1.1-6.1)
WCC 2.4 x109/L (4.0-11.0)
     Neutrophils 2.1  (87) x109/L  (%) (1.8-7.5)
     Lymphocytes 0.28  (11) x109/L  (%) (1.0-3.5)
     Monocytes 0.02  (0.78) x109/L  (%) (0.2-0.8)
     Eosinophils 0.03  (1.2) x109/L  (%) (< 0.5)
     Basophils 0.00  (0.00) x109/L  (%) (< 0.1)
INR 4.7 (0.8-1.2)
APTT 200 Sec. (25-35)
Fibrinogen 0.50 g/L (1.5-4.0)
D-Dimer 20 mg/L (< 0.5)

Film Review: Moderate macrocytosis. Increased rouleaux formation. Pancytopenia. Neutrophils show a left-shift with toxic changes and rod-like inclusions.

68yo female with hypothermia (T≈36°C), hypotension (BP≈70/-) and obtundation.
DIC ∝ Septic Shock
  • consumptive coagulopathy:
    • ↑INR/APTT
    • ↓platelets and ↑IPF (immature platelet forms)
    • ↓fibrinogen and ↑D-dimer
  • leukopenia with relative neutrophilia : PMN ≈ 87%
  • protein C activity ≈ 37% (N:75-160)
  • septic shock → lactate ≈ 6.9 mmol/L

Also, underlying macrocytic anaemia.