A 50-year-old man with a past medical history of rheumatoid arthritis (treated with immunosuppressive biologic agents) presented to the Emergency Department with splenomegaly, fevers, thrombocytopenia (platelets 31 x 109/L). After admission, the patient was noted to have decreased fibrinogen, elevated transaminases and total bilirubin, and a ferritin level of 51,000 mcg/L. The patient’s clinical status worsened, necessitating intensive care. A bone marrow biopsy was performed to evaluate the patient’s condition.
|Andrew Norgan, M.D., Ph.D.
Mayo Clinic Scholar
Instructor in Laboratory Medicine and Pathology
|Bobbi Pritt, M.D.
Consultant, Clinical Microbiology
Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine