Clinical Case 2

A 55-year-old with a background of myelofibrosis is brought to the emergency department by ambulance. She was found by her son with a right-sided weakness and dysphasia. She looks pale and is febrile. Her son tells you she has been unwell for a few days. Her CT brain shows an area of potential acute infarct. Her FBC is below.

Haemoglobin (g/L) 50     (115-165)
Mean Cell Volume (fl) 115     (80-100)
Platelets (109/L) 120      (150-400)
White cell count (109/L) 176         (4-11)
Neutrophils (109/L) 80       (2.0-7.5)
Eosinophils (109/L) 3.0      (0-0.4)
Basophils (109/L) 1.0      (0-0.1)
Monocytes (109/L) 92       (0.2-0.8)
Lymphocytes (109/L) 3.2       (1.5-4.5)