Author: BloodWorks-N.Bakashi and H Al-Zahrani Category: Red Cell: Other Disorders > Bone/metabolic disease > Oxalosis Published Date: 07/28/2012
A 28-year-old woman presented with pancytopenia. Her past medical history was significant for primary hyperoxaluria.
She had recurrent renal stones and urinary tract infections since the age of 5 years. Subsequently she developed uremic
symptoms with end-stage renal disease. For the past 5 years she required regular hemodialysis and transfusions. There was
no history of joint pain, cardiac problems, or brain sequelae of oxalosis. On physical examination she had massive
hepatosplenomegaly but no lymphadenopathy. Liver enzymes and bilirubin were normal and studies for viral hepatitis were
negative. Liver biopsy documented secondary hemochromatosis (transfusion dependent). Laboratory studies showed
pancytopenia with hemoglobin of 63g/L, a white blood cell count of 2.6 109/L, and a platelet count of 106 109/L.
Peripheral blood film showed leukoerythroblastic picture with teardrop poikilocytosis. The anemia persisted with little, if any,
response to erythropoietin, despite the use of high-d