Case 10 – the beginning

An 18 yr old girl presents to A&E complaining of SOB and severe chest pain.

Obs show sats of 87% on room air.  BP 135/80, HR 120bpm, RR 28 and apyrexial.

Routine bloods have been sent which show that she is anaemic.

HB of 72g/dl(ref 130-180).

WCC 14 x10*9/L (4-11)

plt 344×10*9/L (150-400)

U&Es N

ALT 40 (Normal)

ALP124 (normal)

BILI 47 (3-17umol/L)

CRP 120 (<5)

The patient is unable to give any history and there are no previous records for her on the hospital system. What is your initial approach? Possible differential?

Please reply on Twitter and always include #teamhaem to allow others to follow your comments. Please join in the debate and learn about haematological emergencies 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 and debate rather than to provide medical advice.

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Online education and discussion about all things haematological
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