A 42-year-old woman with Trisomy 21 and an unrepaired AV canal that has led to Eisenmenger syndrome. She had secondary polycythemia with hemoglobin usually between 22 and 24 g/dL. She also has a history of ITP and low platelet count. She was admitted for hematemesis and hematochezia, which appeared to be a Mallory-Weiss tear caused by forceful vomiting. Coagulation tests showed: Prothrombin time (PT) 13.4 (reference range 8.3—10.8 sec), INR 1.5 (0.9—1.2). Her CBC showed: Hgb 20.1 g/dL, Hct 61.6%, RBC 5.93 x 106/µl, MCV 103.7 fL, WBC 4.2 x 103/ml, and Platelets 30 x 103/ml.
Ling Wang, B.M., Ph.D.
Resident, Special Coagulation
Dong Chen, M.D., Ph.D
Consultant, Division of Hematopathology
Associate Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine