29th February 2024

A 46-year-old male with a past medical history of asthma, osteoarthritis, depression, and schizophrenia has recently had some routine blood tests.

A 46-year-old male with a past medical history of asthma, osteoarthritis, depression, and schizophrenia has recently had some routine blood tests. He is currently taking citalopram, paracetamol, ibuprofen, and clozapine. He is well but has been experiencing more frequent episodes of wheeze and breathlessness. His blood tests are shown below.

Hb – 130 (115-160g/l)

MCV – 90 (82-100 fl)

Lymph 0.4 x 109 (1.0-3.0 x 109)

Neuts 0.02 x 109 (2.0-7.0 x 109)

WCC 1.6 (4.0-11.0 x 109)

What is the most appropriate management option?