Erythrocytes with coarse basophilic stippling

 In the latest Case Record of the Massachusetts General Hospital, a 59-year-old man was admitted to the hospital because of fatigue, abdominal pain, new anemia, arthralgias, abnormal liver function, and emotional lability. A peripheral-blood smear showed polychromasia and coarse basophilic stippling of erythrocytes.

Acute abdominal pain has a broad differential diagnosis that includes both intraabdominal and extraabdominal causes. Life-threatening intraabdominal catastrophes, such as gastrointestinal perforation, intestinal infarction, and a ruptured abdominal aortic aneurysm, cause illness within minutes or hours.

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Case 12-2014 — A 59-Year-Old Man with Fatigue, Abdominal Pain, Anemia, and Abnormal Liver Function 

Source: NEJM