
The Clinical Problem Solvers
Episode 343 – Clinical Unknown – Ravi and Reza dealing with silent jaundice
Jul 5, 2024
Ravi and Reza discuss a case of silent jaundice in a 76-year-old woman, exploring potential causes such as primary biliary cirrhosis, chronic lymphocytic leukemia, and autoimmune hemolytic anemia. They focus on the diagnostic journey, including lab interpretations and treatment options, emphasizing the importance of clinical expertise and problem-solving skills.
35:00
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Quick takeaways
- Laboratory results guided diagnosis of warm autoimmune hemolytic anemia, emphasizing Coombs test importance.
- Integrating patient history, physical exam, and lab data is vital for accurate diagnosis in jaundiced patients.
Deep dives
Diagnosis of Warm Autoimmune Hemolytic Anemia
A 76-year-old female presented with silent jaundice, lacking associated symptoms, but with dark urine. Lab results indicated anemia with high white blood cell count primarily lymphocytes, low platelet count, and elevated total bilirubin. CT scan showed splenomegaly and diffuse lymphadenopathy. A Coombs test confirmed warm autoimmune hemolytic anemia secondary to CLL, managed with prednisone and rituximab, leading to improved hemoglobin levels.
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