Help me diagnose this case 61 yrs old known DM on ameryl HTN on amlodipine for 10 yrs or more, Presented with left side weakness, slurred speech, deviation of the mouth with nausea Dark urine for 2 days before, with Vague abd pain, CT brain showed thrombosis MCA, Pt also jaundiced CBC low HP 7.8 and high retics blood film neutrophilia and pitted cells no malaria plt normal KFT normal ALT, AST normal Indirect hyperbilrubenimia LDH 1000 CK high Cardiac enzymes normal ECG normal Pt desaturating in room air down to 80s no SOB no destress BP stable, RBS 16 Blood gas normal any ideas?
I think it is a case of hemolytic anemia, probably PNH.