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Case Report
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| "Flowers" in the blood: A novel paired erythrocyte arrangement in a patient with chronic fatigue syndrome following infectious mononucleosis | ||||||
| Carrie E Burdzinski | ||||||
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MS, Assistant Professor, Department of Biology, Delta College, University Center, Michigan, USA.
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| How to cite this article |
| Burdzinski CE. "Flowers" in the blood: A novel paired erythrocyte arrangement in a patient with chronic fatigue syndrome following infectious mononucleosis. Int J Case Rep Images 2014;5(8):562–566. |
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Abstract
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Introduction:
Chronic fatigue syndrome is a debilitating condition characterized by persistent fatigue, post-exertional malaise, myalgia, arthralgia, lymph node tenderness, impaired memory and concentration, autonomic irregularities, and other specific symptoms affecting multiple body systems. Diverse hypotheses have been investigated to ascertain the disease etiology. Some of these include metabolic and mitochondrial deficiencies, exposure to environmental toxins, dysautonomia associated with orthostatic intolerance, autoimmune reactions, neuroendocrine aberrations, and chronic viral infections. However, a consistently observed biomarker for chronic fatigue has not been identified. A comprehensive, standardized strategy for accurate diagnosis and successful treatment remains elusive.
Case Report: A 28-year-old Caucasian female presented with chronic fatigue persisting for nine months following infectious mononucleosis. Laboratory evaluation excluded classic causes of fatigue. Peripheral blood smear examination revealed numerous pairs of unusual nondiscocytic C-shaped erythrocytes, coupled in perpendicular crosses resembling four-petalled flowers. The presence of the erythrocyte pairs abated with the patient's recovery from chronic fatigue syndrome over a 24-month period. This erythrocyte arrangement has not been reported elsewhere in medical literature. Conclusion: A novel erythrocyte "flower" formation was identified in a patient with chronic fatigue syndrome. The presence of this arrangement paralleled the course of the illness and was no longer observed upon recovery. The physiological relevance of the structure remains a subject for future research. Several hypotheses are suggested, including enhanced membrane deformability resulting from elevated catecholamine levels, and immune-mediated agglutination, possibly stemming from viral infection. | |
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Keywords:
Chronic fatigue syndrome, Infectious mononucleosis, Erythrocytes, Hematology
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Author Contributions
Carrie E Burdzinski – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2014 Carrie E Burdzinski. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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