Author Archives: TeamHaem

About TeamHaem

Online education and discussion about all things haematological

Case 109 – summary

Thanks for all your help this week. This week’s case focused on Thrombocytopenia pregnancy that ultimately was ITP responsive to steroid therapy. Mild gestational thrombocytopenia (with platelet counts <150×10^9/L) is common affecting up 5-10% of pregnant women. Pregnant women with … Continue reading

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Case 109 – update 4

Thanks for your help so far. The lady thankfully had an uneventful normal vaginal delivery. She had chance to have an anaesthetics review prior to labour and had been attending joint obstetric and haematology clinic. Her pre prepared birth plan … Continue reading

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Case109 – update 3

The lady’s platelet count responded to 20mg Prednisolone and is now at 65×10^9 at 38 weeks gestation.  The obstetric team are keen for a plan for delivery what advice would you give the team?  What advice would you give to the … Continue reading

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Case 109 – update 2

You suspected ITP or possibly gestational thrombocytopenia and embarked on monitoring her platelet counts every few weeks. The lady is now 34 weeks pregnant and is otherwise well. Her platelet count has started to fall over the past 6 weeks and is now … Continue reading

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Case 109 – update 1

The lady had a repeat FBC that confirmed isolated thrombocytopenia with a platelet count of 80×10^9/l Her blood film is shown below you check carefully and there are no platelet clumps. Her CD61 platelet count is 75×10^9/l You establish that she … Continue reading

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Case 109 – the beginning

A 32 year lady is 11 weeks pregnant. She has had her booking blood tests performed by her midwife and her FBC has shown an isolated thrombocytopenia of 90×10^9.  What History would you like ask her? What investigations would you … Continue reading

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Case 108 – Summary!

Thank you for everybody’s contributions throughout the week! We focused upon a 32 year old man who presented with asymptomatic unilateral cervical lymphadenopathy and was subsequently diagnosed with limited stage nodular lymphocyte predominant hodgkin lymphoma (NLPHL). He was treated with … Continue reading

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Case 108 – Update 4!

Our patient achieved complete metabolic remission following #6 R-CHOP chemotherapy for his relapsed advanced stage NLPHL. Unfortunately 18 months after completing treatment he attended with drenching night sweats, intermittent fevers and marked malaise. His spleen was palpable just below the … Continue reading

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Case 108 – Update 3!

Thank you for the ongoing contributions to our case! Our patient achieved a complete response following radiotherapy treatment alone (30Gy) and remained under haematology follow-up. Unfortunately 5 years later he attends the haematology clinic earlier than scheduled as he has … Continue reading

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Case 108 – Update 2!

Thank you for everyone’s contributions in obtaining the diagnosis of Nodular Lymphocyte-Predominant Hodgkin Lymphoma (NLPHL)! The lymph node morphology demonstrates large atypical cells with multiple nucleoli (lymphocyte-predominant cells) embedded within follicles. The IHC is as follows: Lymphocyte-predominant cells:CD20+, CD45+, CD75+, … Continue reading

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Case 108 – Update 1!

Thank you to all the contributions so far! We have now established that our 32 year old mans neck mass has been gradually increasing in size since he noted it 6 months ago. He has otherwise been well in himself … Continue reading

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Case 108 – Update 1

Thank you to all the contributions so far! We have now established that our 32 year old mans neck mass has been gradually increasing in size since he noted it 6 months ago. He has otherwise been well in himself … Continue reading

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Case 108 – The Beginning

You review a 32 year old man in outpatients who has been referred for a neck lump. On examination he has a 2cm cervical lymph node which he originally noticed approximately 6 months ago. He has had no night sweats … Continue reading

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Case 107 – summary

Thank you for your contribution in this week’s #teamhaem case. This week we have been looking at Transient Leukaemia of Down Syndrome (TL-DS). Background Between 5%- 30% children with Down syndrome (DS) are born with Transient Leukaemia of Down syndrome … Continue reading

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Case 107 – update 3

CXR and ECHO show no significant abnormalities. Abdo USS confirms hepatosplenomegaly but no ascites. There are no skin rashes and his blood tests are stable. Blood film report: Polycythaemic film. Pleomorphic blasts with evidence of cytoplasmic blebbing. Manual blast count … Continue reading

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Case 107 – update 2

You think the baby has some dysmorphic features. You look at his blood film. You also check his conjugated bilirubin and request CXR, abdominal USS and ECHO. Questions: 1. What are the main features and why? 2. What factors might … Continue reading

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Case 107 – update 1

You meet the baby with his mother. He was a little floppy at birth and not feeding well with a low grade fever. He is on 2L oxygen but with no respiratory distress. He is visibly jaundiced. The mother is … Continue reading

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Case 107 – the beginning

Welcome to our new #TeamHaem case. You are the haematology registrar. You get a phone call from a junior doctor on the neonatal ward. They have a 2 day old baby boy with jaundice. The baby seems stable, though he … Continue reading

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Case 106 – Summary

Thank you all for your contributions this week.   We focused on a patient with a new diagnosis of primary immune thrombocytopenia (ITP), please refer to TeamHaem case 11 for a full summary of this condition.   In the wake … Continue reading

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Case 106 – update 2

Our patient is in haematology outpatient clinic. We have excluded any secondary causes for an isolated thrombocytopenia and are considering first line therapy with prednisolone 1mg/kg/day with gastric protection (our local #TeamHaem preference). We have considered the potential risks of … Continue reading

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