These peripheral blood smears belong to a 21-year-old lady who had come to us with complaints of progressive pallor and jaundice. She had received 1 unit of Packed red blood cells (RBC) transfusion 3 weeks back. There were similar episodes in the past since the age of 10 years, necessitating intermittent blood transfusions.

The complete hemogram was as follows: haemoglobin: 7.6gm/dl, mean corpuscular volume: 69fl, mean corpuscular haemoglobin: 28pg, total leucocyte count: 4200/dl, and platelets: 1.6 lakhs/dl.

The photomicrographs of the Leishman stained peripheral blood smears (100X), show microcytic hypochromic RBCs with anisocytosis, polychromasia, target cells and sickle cells. Neutrophils with normal morphology are depicted on the smears. The platelet count is adequate on the smear.

The diagnosis was confirmed as Sickle β Thalassemia, by a Mutation analysis done from the peripheral blood.