Pathways Case Study: March 24


A 35-year-old female presented with a month-long history of worsening symptoms: flushing, rash, joint/muscle pain, weakness, difficulty walking, and head tremors. She had high blood pressure and tachycardia. An extensive workup was performed, including consults with Cardiology, Neurology, and Rheumatology. No unifying explanation was found for the patient’s multitude of symptoms. CBC and peripheral blood smear were normal. Her doctor noted slightly elevated serum tryptase = 15 (normal <11.5) and requested an Allergy consult. Subsequently, a bone marrow biopsy was ordered (see photos above).

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Lisa Hartzheim, MT (ASCP)
Education Program Coordinator
Department of Laboratory Medicine and Pathology
Mayo Clinic
Instructor in Laboratory Medicine and Pathology,
Mayo Clinic College of Medicine



Mechelle Miller

Mechelle Miller, BS, MT, MLT (ASCP)
Technical Specialist
Department of Laboratory Medicine and Pathology
Mayo Clinic



April Josselyn is a Marketing Channel Manager at Mayo Clinic Laboratories. She has worked at Mayo Clinic since 2012. Outside of work, April enjoys the outdoors and being "hockey mom" for her two sports-crazed boys.