A 55-year old non-alcoholic farmer male patient with a history of recurrent blood transfusion (8-10 times in a year). On examination signs of splenomegaly were observed. No blood loss, No fever/cough/cold / expectoration- Cachexic look Esr >150 Retic 0.3%, Pscm . Severe degree dimorphic anemia with leucopenia, Anisopoikilocytes, Macrocyctes Teardrop cells.
Hb 4.3, WBC 2.7k, Platelets 123k, RDW 28.5, Blood group O negative, Chest X-ray, and HBsAg/HCV/s.rvd negative Abdominal ultrasonography. Splenomegaly (13.5), normal echo Liver, and Lymphadenopathy.
