Case 9 – update 1

*For start of case see https://teamhaem.wordpress.com/2013/05/07/case-9-may-2013/ *

Okay.  We’ve done bloods:

FBC: Hb 136 g/L, WCC 6.7×10*9 (differential normal), PLT 178×10*9

U&E: Na 137, K 3.9, Creat 67, urea 4.5

LFT: normal

Calcium 2.2 (normal)

Further history suggests that the patient has lost about half a stone over the past few months and the itch that was mentioned previously has been persistent over the past four months.  There’s no rash to speak of and steroid creams have not helped.  An antihistamine at night has allowed her to sleep and she’s awaiting dermatology review.  No night sweats, but often feels flushed during the day.  She states she feels the “blood rushing to her head” when she lies down at times.

Questions

  • What worries you now?
  • Investigations?
  • Any further blood tests?
  • Would you admit to hospital?

Please reply on Twitter and always include #teamhaem to allow others to follow your comments. Please join in the debate and learn about haematological problems along the way. The case will continue to  evolve over the coming week so keep checking #teamhaem for more information.

Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.

TeamHaem are not a position of authority.  It is an educational platform to allow discussion

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Online education and discussion about all things haematological
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