Author Archives: TeamHaem

About TeamHaem

Online education and discussion about all things haematological

Case 92 – summary

Thanks for your help with the cases. This week we have looked at three different scenarios regarding bleeding or bruising presenting in the paediatric population. The cases although different have some common themes: Coagulation testing in paediatrics is challenging for … Continue reading

Posted in Acquired bleeding, Inherited bleeding, Paediatric haematology | Tagged , , , , , , , , , , , , , , , ,

Case 92- update part C

We have a 7 year old boy who has presented with bruises over abdomen and one on his ear. Social services have been contacted as there is concern this may be an NAI. The boy is otherwise well has no … Continue reading

Posted in Acquired bleeding, Inherited bleeding, Paediatric haematology | Tagged , , , ,

Case 92 – part C

Thanks for your help with case 2 the patient has been diagnosed with Ehlers Danlos and will have an echo arranged to check for any cardiac problems. You now receive a call from the local district general hospital regarding a … Continue reading

Posted in Acquired bleeding, Inherited bleeding | Tagged , , , ,

Case 92 – part B

Thanks for your help with case 1 the baby is improving. The following morning you as the Haematology registrar have been referred a 5 year old girl who presented due to parental concern with easy bruising. The bruising was noted … Continue reading

Posted in Acquired bleeding, Inherited bleeding, Paediatric haematology | Tagged , , , , , ,

Case 92 – update part A

Thanks for your help so far An 8 week old baby boy born at 40+2 by Normal vaginal delivery has a CT that confirms a subdural haemorrhage. Results: (With age adjusted reference ranges) FBC – Hb 120 (Low) MCV 120 … Continue reading

Posted in Acquired bleeding, Inherited bleeding, Paediatric haematology | Tagged , , , , , ,

Case 92 – the beginning

This week we will be looking at investigation of bleeding and bruising in the paediatric setting with three short cases. Case 1 An 8 week old baby boy born at 40+2 by Normal vaginal delivery presents with a reduced consciousness … Continue reading

Posted in Acquired bleeding, Inherited bleeding, Paediatric haematology | Tagged , , , , ,

Case 91 – summary

Thank you for all your contributions this week! This week we had a look at MGUS (monoclonal gammopathy of undetermined significance). Our patient was diagnosed with IgA lambda MGUS, which was monitored 6 monthly for 4 years. This then progresses … Continue reading

Posted in Myeloma/paraproteins | Tagged , , ,

Case 91 – update 2

We have been monitoring our patient 6 monthly for 4 years. His para protein has been slowly rising and was 10g/l on his last visit 3 months ago. He has been bought to clinic slightly earlier to monitor his paraprotein. … Continue reading

Posted in Myeloma/paraproteins | Tagged , , ,

Case 91 – update 1

So our patient has been seen by haematology. He initially presented with shoulder pain. Following X-ray and MRI this has been shown to be due to osteoarthritis with no evidence of lytic lesions. Bone marrow had shown a normocellular marrow … Continue reading

Posted in Myeloma/paraproteins | Tagged , , ,

Case 91 – the beginning

Welcome to this week’s TeamHaem case! This week we start in general practice. A 70 year old man saw your colleague complaining of shoulder pain. Some bloods were done as he was due his ‘well man’ bloods around the same … Continue reading

Posted in Myeloma/paraproteins | Tagged , , ,

Case 90 – summary

We started with a 74 year old gentleman who was admitted with weight loss, fatigue and change in bowel habit. A mass in the right iliac fossa was palpated and a colonic malignancy was suspected. He had thrombocytosis with microcytic indices … Continue reading

Posted in Anaemia, Laboratory morphology, Transfusion | Tagged , , , , , , , , , ,

Case 90 – update 4

Here is the antibody panel. Can you identify the antibody?  

Posted in Anaemia, Laboratory morphology, Transfusion | Tagged , , , , , , ,

Case 90 – update 3

Our patient is one week post two units of blood and his haemoglobin is back to baseline and has hyperbilirubinaemia. LDH is elevated and haptoglobins are absent. Blood film shows spherocytes. Here is the antibody screen Questions (For fun!) can … Continue reading

Posted in Anaemia, Laboratory morphology, Transfusion | Tagged , , , , , , , ,

Case 90 – update 2

Our patient is treated for potential pulmonary oedema associated with blood transfusion (transfusion-associated circulatory overload). The differential was TRALI but given its rarity and the patient’s observations (hypertension and a positive fluid balance) TACO was felt to be more likely. … Continue reading

Posted in Anaemia, Transfusion | Tagged , , , , , , ,

Case 90 – update 1

Our patient has deteriorated towards the end of a two unit transfusion. He is short of breath and more hypoxic compared to previous. Observations are below:   Before unit one Towards end unit two Pulse 72bpm 98bpm Blood pressure 100/70mmHg … Continue reading

Posted in Anaemia, Transfusion | Tagged , , , , ,

Case 90 – the beginning

A 74 year old male is admitted to hospital with weight loss, fatigue and change in bowel habit. He is pale and a mass is palpated in the right iliac fossa. A full blood count is performed: Hb 72g/l MCV … Continue reading

Posted in Anaemia, Transfusion | Tagged , , , , ,

Case 89 – summary

  Thank you for all of the contributions with Case 89 where we encountered a fit 64 year old who presented with progressive anaemia and leucocytosis over the past 6 months. He also had associated weight loss of 0.5 stones … Continue reading

Posted in Anaemia, Myeloproliferative neoplasm | Tagged , , , , ,

Case 89 – update 2

Thank you for everyone’s contributions so far! Update of investigation results as requested: Bone marrow trephine: myelofibrosis. BM cytogenetics: monosomy 7 Peripheral blood: JAK2 positive. No circulating blasts identified on blood film. USS abdo: 16cm spleen (Hb 95, Plts 90, … Continue reading

Posted in Anaemia, Myeloproliferative neoplasm, Uncategorised | Tagged , , , , ,

Case 89 – update 1

Thanks for everyones contributions so far. Further information now available as requested by yourselves: Patient decline over past 6 months – 0.5 stone weight loss, no night sweats / fevers. Marked lethargy and generally feeling ‘achey’. Poor appetite but no … Continue reading

Posted in Anaemia, Laboratory morphology, Myeloproliferative neoplasm | Tagged , , , ,

Case 89 – the beginning

A 64  year old man is referred to haematology outpatients with progressive chronic anaemia and leucocytosis. He has previously been very fit but has become very lethargic  over the past few months. Hb 95, MCV 103, Plts 90, WCC 17, … Continue reading

Posted in Anaemia, Myeloproliferative neoplasm | Tagged , , ,