Images in Clinical Medicine

Erythrophagocytosis

Giambattista Lobreglio, M.D., and Antonio Valacca, M.D.

N Engl J Med 2001; 344:897March 22, 2001

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Figure 1 A 50-year-old woman presented with fatigue, pallor, and jaundice after taking cefotetan and netilmicin for a respiratory tract infection. The hemoglobin level was 3.1 g per deciliter, the red-cell count was 960,000 per cubic millimeter, the total bilirubin level was 5.4 mg per deciliter (92 μmol per liter), and the direct Coombs' test was strongly positive (++++), indicating the occurrence of immune hemolytic anemia. A peripheral-blood smear stained with May–Grunwald–Giemsa stain (×1400) showed granulocytes that had phagocytized erythrocytes (erythrophagocytosis). The patient's condition deteriorated rapidly, and she died suddenly before transfusions could be administered and before further laboratory tests could be performed to determine the nature of the immune hemolytic anemia (i.e., whether it was associated with an infection, induced by drugs, or related to reactive autoantibodies).

Giambattista Lobreglio, M.D.
Antonio Valacca, M.D.
Vito Fazzi General Hospital, 73100 Lecce, Italy

Citing Articles (2)

Citing Articles

1. 1

   Kazuhisa Kuwata, Shoko Yamada, Etsuo Kinuwaki, Makoto Naito, Hiroaki Mitsuya. (2006) PERIPHERAL HEMOPHAGOCYTOSIS. Shock 25:4, 344-350
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2. 2

   George Garratty. (2001) Erythrophagocytosis on the peripheral blood smear and paroxysmal cold hemoglobinuria. Transfusion 41:8, 1073-1073
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