Rather than another diagnosis of painful crisis, she had refractory anemia with excess blasts in transformation (RAEB-T). leukemia, or sickle cell disease, although occasionally abrupt, also typically present. The bone marrow was hypocellular with megaloblastic changes, but with 15 % leukemic cells. Immature cells were also present, some of which contained Auer rods (see above). male with a long history of SCD with clinical jaundice and scleral icterus. A peripheral smear showed sickle forms and targets. For many patients with sickle cell disease (SCD), jaundice is a significant. In retrospect, granulocytopenia and thrombocytopenia had been evolving over the past several months. The clinical picture was thought to be consistent with sickle cell painful crisis, but the white blood cell count was 3.7 × 10 9/L granulocyte count, 1.0 × 10 9/L and platelet count, 110 × 10 9/L. This can lead to organ damage, most common in the kidneys, liver, spleen, lungs, brain, and eyes. As a result of vaso-occlusion, or blocked blood vessels, organs can be deprived of oxygen. Her physical exam showed slight fever, some scleral icterus, and a tender abdomen with normal bowel sounds. There are several complications of sickle cell anemia for which affected individuals should be watched. When seen, she was writhing in pain and asking for narcotics. Her numerous previous medical problems included intermittent bone pains, infections, and chest pains. A 66-year-old African American woman with lifelong anemia and a positive family history of anemia came to the emergency room with abdominal pain.
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