Case 106 – update 1

You are checking the results from yesterday’s surgery and review our patients consultation notes:

61 year old female, previously fit and well

·        Easy bruising over both lower limbs for 2-3 weeks. No constitutional symptoms

·        No significant past medical history

·        No previous bleeding history

·        No family history of bleeding disorders

·        Moderate alcohol intake. Non-smoker

·        Recently separated from a long-term partner. No concerns about trauma or physical abuse

·        Physical examination unremarkable other than several 2-3cm bruises over both legs and faint petechiae

The lab have called through her results:

Hb 120, MCV 82, Plt 8, WCC 6, Neutrophil 4

Coagulation screen shows PT, APTT, Fibrinogen results within the normal range

Autoimmune and viral screens are unremarkable

There is an added film comment:

Genuine thrombocytopenia. No aggregates on film or clot in sample. Occasional large platelet present. No primitive cells. Morphology otherwise unremarkable. 

 

Questions:

  1. How do you interpret these results?

  1. What action do you take?

Join us on Twitter @TeamHaem and let us know what your thoughts are, what questions you have and what you want to do as we see this case evolve over the next week. 

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