Case Report

Severe Aplastic Anemia as First Manifestation of Classical Hodgkin Lymphoma

Table 1

Patient’s initial blood workup.

Laboratorial hematology

Hemogram
Hemoglobin5.8 g/dL
Leucocytes2.8 × 109/L
Neutrophils1.36 × 109/L
Platelets<10 × 109/L
Reticulocytes26 × 109/L
Erythrocyte sedimentation rate92 mm/h

Biochemical profile
Creatinine65.43 μmol/L
Alanine/aspartate aminotransferase28/32 U/L
Total bilirubin15.56 μmol/L
Triglycerides1.12 mmol/L
Ferritin553 μg/L
LDH221 U/L
β2-microglobulin1.98 mg/L

Immunologic screening
Antinuclear antibodies (ANA) (immunofluorescence)
Antineutrophil cytoplasmic antibodies (c-ANCA) (immunofluorescence)
Antineutrophil cytoplasmic antibodies (p-ANCA) (immunofluorescence)
<1/160 (1/160)
<1/20 (<1/10)
<1/20 (<1/10)

Serological/microbiological screening
Interferon gamma release assay (IGRA) for Mycobacterium tuberculosis infection (in vitro stimulation)<0.01 UI/mL
Human hepatitis virus B (HBs antigen)<0.10 (<1.00)
Human hepatitis virus B (HBs antibody)0.16 (<1.40)
Human hepatitis virus B (HBs antibody)13.78 m UI/mL (<8.00)
Human Hepatitis virus C antibody0.21 (<1.00)
Human immunodeficiency virus0.10 (<0.90)
Epstein-Barr virus, viral capsid antigen (VCA) IgM antibody
Epstein-Barr virus, viral capsid antigen (VCA) IgG antibody
0.40 RU/mL (<0.80)
97.10 RU/mL (<16.00)
Cytomegalovirus, IgM antibody
Cytomegalovirus, IgG antibody
0.15 UA/mL (<0.90)
11.80 UA/mL (<0.90)
Parvovirus B19, IgM antibody (immunoassay)
Parvovirus B19, IgG antibody (immunoassay)
Nonreactive
3 UI/mL
Venereal Disease Research Laboratory (VDRL) test
Treponema pallidum haemagglutination assay (TPHA)
Nonreactive
Negative
Rubella virus, IgM antibody
Rubella virus, IgG antibody
0.00 UI/mL (<0.80)
16.50 UI/mL (<5.00)
Toxoplasma gondii, IgM antibody
Toxoplasma gondii, IgG antibody
0.20 UI/mL (<0.90)
5.20 UI/mL (<6.40)
Borrelia burgdorferi screening antibodies (enzyme-fluorescent assay)Nonreactive
Bartonella henselae, IgM antibody (indirect immunofluorescence)
Bartonella henselae, IgG antibody (indirect immunofluorescence)
Nonreactive
<320
NGS panel (genes tested)
ASXL1, CEBPA, NPM1, ETV6, FLT3, CSF3R, DNMT3A, EZH2, GATA1, IDH1-2, IKZF1, RUNX1, SFEB1, TET2, WT1, TP53Unmutated