Highlights
A 70-year-old male visited the Haematology clinic because of tiredness and feeling generally unwell for about two months. He had no fever, and did not notice colour changes of urine or stool. He denied alcohol use and described his diet as ‘good’. Physical examination revealed pale conjunctiva, and there was a loss of vibratory sense in the bilateral upper and lower distal extremities and loss of proprioception bilaterally in the toes. There was no lymphadenopathy or hepatosplenomegaly present
a. What are the features of the full blood count results?
b. Which morphological abnormalities are present in the blood film? Which disease(s) may show such morphological abnormalities?
c. What is the most likely diagnosis for this patient? Please provide the supporting evidence?
d. Which additional laboratory investigations are needed to confirm the diagnosis? Please provide the predicted results?
e. How does anaemia develop in this case? How do you explain the patient’s neurological manifestations
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