Quality Over Quantity: A Case of Too Big
1. Clinical Assistant Professor, Stanford University, Palo Alto, CA
2. Clinical Associate Professor, Stanford University; Palo Alto, CA
3. Professor, Stanford University; Palo Alto, CA
A 19-year-old woman presented to clinic for evaluation of thrombocytopenia incidentally noted on her annual physical. She had normal menstrual periods and denies any personal or family history of bleeding or bruising. While she had no other significant medical history, her family history revealed that her father needed hearing aids at a young age. Laboratory studies showed a white blood cell count of 7.3 × 109/L with a normal differential, hemoglobin of 12.9 g/dL, and platelet count of 81 × 109/L. Platelet aggregometry showed normal aggregation to arachidonic acid, adenosine diphosphate (ADP), collagen, epinephrine, and ristocetin. Her peripheral smear revealed the following (Figure):
Dr. Chien, Dr. Lo, and Dr. Glader indicated no relevant conflicts of interest.