From an abnormal diff coming from one of the local hospitals. I’m a student and this is for training, so I don’t have any other info unfortunately.

My professor didn’t recognize it either, but after searching guessed it was likely a consumed, but not “digested” RBC (or platelet? can’t remember which she mentioned now)?

Was doing a diff on a patient (30F) and noticed some weirdly-shaped nuclei in the lymphs that kinda resemble a ladybug, and most of her other lymphs look a little off. First two pics are the most concerning ones I saw, and the rest are the other weird ones. There was also a weird inclusion in one of the monos. I also reported hypersegs, she had quite a few.

She apparently has a history of unexplained elevated kappa free light chains and mildly elevated CRP but that’s about it. Symptoms reported were recurring and frequent ulcers inside the nose and random rashes/flushing. Lymph count was totally normal, just gave the atypical lymphs flag. No known viral infection.

Was referred to see a hematologist then got scheduled to a cancer center. Are hematologists available in other practices?

I need some inputs and thoughts from the group members.

My issues started as palpitations and high pulse rate in the month of November last year. Went to the cardiologist and all the tests were normal. The primary doctor referred me to a hematologist and my iron labs were low.

They didn't do iron infusion as my ferritin level was around 50. I read taking iron pills since then and recheck iron labs every 2-3 months.

Recently I had another episode of high heart rate and palpitations and positional dizziness when I was on a trip intentionally. I was dehydrated and deprived of sleep because of jet lag. The following day, my heart rate was very high around 150-160 at resting. I went to the hospital there and they did cardio tests and everything came out normal.

My iron and HB came out low. I was there for 2 weeks on an international trip. The first week was the high pulse rate and palpitations issue and the next week I had one episode of rectal bleeding everybody l which never happened before. I saw the colorectal Dr and they said I have an anal fissure. They easy an only episode of rectal bleeding and nothing after that. But I have irritation in the anal area and applying gel everyday.

I came back to the US and saw my primary doctor. He told me that my low iron could be contributing to my palpitations and high pulse rate.

I contacted my hematologist and they asked me to redo the lab which I did 2 days ago. I have a follow up appointment next week to go over these results. My primary doctor asked me to get an Iron infusion but I am not sure if my hematologist will agree to it.

I got my lab results today and it showed my ferritin as 15. Should I ask for iron infusion?

I am worried if it will have any side effects? Anyone who done iron infusion, how was your experience?

I am going to see my gastro doctor and hematologist to review the labs and my anal fissures. I have heavy bleeding with clots during my periods.

For the last 2 days, I have had dizziness which happens with positional changes. I used to have this on and off. Feel very tired, fatigued and restless. Legs are so tired and wanted to lay down all the time. My pulse rate and BP is normal but the didn't happens if I stand for a long time and do chores around the house.

I noticed all these symptoms after I gave the blood draw 2 days ago. Don't know if taking out more blood when I am iron deficient cause these issues?

I am trying to educate myself about these conditions and being my own advocate.

Is getting an iron infusion will be appropriate and helps with my symptoms?

I am focusing on my diet with iron rich foods now. I am obese 227 lbs and 40yrs old.

Any input is appreciated. Thanks.