A 34 yr old female developed puffiness around eyelids and frequent headaches with fever on and off for one month, visited her consultant who advised for routine blood examination to find low RBC count. Peripheral blood smear showed normochromic and normocytic erythrocytes , without any inclusions. P-63, L-34, E-2, M-1. no immature cells seen.thrombocytes - normal. Bone marrow showed slightly decreased cellularity, decreased megakaryocytes concluding as mild marrow hypoplasia. ANA profile done , showed strong positive for SS - A (Ro), Ro52, SS - B(La), dsDNA, Nucleosomes, AMA-M2.
USG - Abdomen showed mild fatty liver, cholelithiasis, mild spleenomegaly,bilateral renal calculi, mild free fluid in pelvis. she was transfused with one unit of blood. for a day she felt better and then become worse. Then she is now referred to a tertiary care centre. This is a relative of my colleague and…
