Case 34 – update 2

We have a patient with sickle cell anaemia post op who is now more anaemic. She also has a sickle cell crisis with abdominal pain. She has a rather elevated CRP which may be post op or due to the sickle cell, but we decide to start emperic antibiotics.

Potential causes of anaemia:

  • Surgical blood losses – remember she is post op
  • Other blood losses – GI bleeding etc.
  • Haematinic deficiency (unlikely to come on so acutely)
  • Haemolytic transfusion reaction
  • Hyperhaemolysis syndrome
  • Parvovirus

Arterial blood gas (on air) reveals PaO2 10.1, PaCO2 4.3, HCO3 21, pH 7.36

Blood film shows sickle cells and very occasional spherocytes.

USS abdomen shows no collections, but surgeons keen for CT scan, although don’t think the pattern fits with surgical blood loss.


  • How do you investigate a transfusion reaction?
  • What complications are sickle patients at risk post op?

Please reply to us (@teamhaem) 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 and learning.

About TeamHaem

Online education and discussion about all things haematological
This entry was posted in Haemoglobinopathy, Transfusion and tagged , , , , . Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s