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Author Archives: TeamHaem
Update 5
After 2 weeks the patient stopped taking the iron tablets as she was struggling with abdominal discomfort and constipation. She is prescribed an IV iron infusion for later that week and attends for this but unfortunately she notices some discomfort … Continue reading
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Update 4
The patient did not attend any further appointment for follow up FBC or her 28 week appt. At 36 weeks she finally attended her midwife appointment and her FBC was as follows: Hb 80g/L MCV 76fL MCH 22.7pg MCHC 31.2% … Continue reading
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Update 3
As most of you told us the film shows microcytic red cells with occasional pencil cells and target cells. Some of you mentioned variable haemoglobinisation, some macrocytic cells, occasional spherocytes and suggested we check folate and vitamin B12 levels and … Continue reading
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Case 125 – update 1
Our lady who is 8 weeks pregnant and feeling a little tired and sickly has a microcytic anaemia. You suggested that the most likely cause of the anaemia is iron deficiency but that we couldn’t rule out a haemoglobinopathy with … Continue reading
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Case 125 – the beginning
A 19 yr old lady attends the GP surgery for her booking appointment. She thinks she is about 8 weeks pregnant. She feels a little nauseous and weary but has no significant past medical history and has not been taking … Continue reading
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Case 124 – Summary
Many thanks for all of your input this week. We covered the case of a 68 year old lady presenting with macrocytic anaemia and thrombocytosis. Key points in initial investigation: Exclude common causes – iron deficiency, B12/folate deficiency, myeloma screen, … Continue reading
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Case 124 – Update 2
Thank you for all of your input and suggestions. To summarise the case thus far: 68 year old lady referred with a macrocytic anaemia and thrombocytosis: Haemoglobin 87 g/L (115 – 165) White cell count 5.2 x 109/L … Continue reading
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Case 124 – Update 1
We are investigating a 68 year old lady referred with a macrocytic anaemia and thrombocytosis. Thanks for all of your helpful input thus far. Tests you have requested to date: Haemoglobin 87 g/L (115 – 165) White cell count … Continue reading
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Case 124 – The beginning
You are helping out in new patient haematology clinic. You have just had your post-lunch coffee and are raring to go! The next patient has been referred via the 2ww pathway by their GP for investigation of an abnormal FBC, … Continue reading
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case 123 summary
Our case this week looked at a 44 year old gentleman with a new diagnosis of AML. He presented with pancytopenia and blasts with auer rods on peripheral blood. Investigations confirmed a diagnosis of AML. PML – RARA was negative, … Continue reading
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Case 123 update 2
The plan is to commence treatment with DA+myelotarg Cytogenetic and molecular studies show t(8:21) C-KIT positive FLT3 negative NPM1 negative Would this change your management? How are you going to monitor response in this patient?
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Case 123 update 1
Our 44 year old male presented with the following full blood count Hb 62 WCC 35 plt 22 Blood film identified blasts, with auer rods. Blood film shows blasts cells, auer rods noted, thrombocytopenia and anaemia. Differential has included AML … Continue reading
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Case 123
44 year old man present to GP with fatigue, SOB and petechial rash. What investigations would you perform? Level of urgency?? Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please … Continue reading
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Team Haem saves Christmas: The Summary
Jingle bells, jingle bells Jingle all the way Oh what fun it is to tweet TeamHaem’s case today! The haemolysis is self-limiting No more parasites are seen The pitted red cells that have lost malaria Are being chomped up … Continue reading
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TeamHaem Saves Christmas Part 3
Jingle bells, jingle bells Jingle all the way Oh what fun it is to tweet TeamHaem’s case today! Whilst sorting through the letters Poor Jingle remembers a bite A sneaky mosquito from an envelope Then that naughty insect took … Continue reading
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TeamHaem Saves Christmas Part 2
Jingle bells, jingle bells Jingle all the way Oh what fun it is to tweet TeamHaem’s case today! Father Christmas is so worried Jingle sorts out both his lists He checks on who’s behaving And makes sure no-one’s missed. … Continue reading
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TeamHaem help us save Christmas 2019! 🎄❄️ Part 1
Jingle bells, jingle bells Jingle all the way Oh what fun it is to tweet TeamHaem’s case today! A day or two ago Father Christmas needed help Jingle, his top packing elf, Just wasn’t feeling himself Jingle bells, jingle bells Jingle … Continue reading
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Case 121 – Summary!
This week we followed our patient with relapsed/refractory DLBCL through CAR T-cell therapy. We managed her cytokine release syndrome (CRS) and she is in remission thus far. CAR T-cell therapy Chimeric Antigen Receptor (CAR) T-cells are modified T cells in … Continue reading
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Case 121 – update 3!
We manage our patient with CAR T-cell therapy related CRS/ICANS with supportive care, including organ support from our critical care colleagues, and tocilizumab (anti-IL-6) therapy. She responds well to therapy and is stepped down to the haematology ward for ongoing … Continue reading
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Case 121 – Update 2!
We suspect cytokine-release syndrome (CRS) in our patient 5 days post CAR T-cell infusion. We manage her with aggressive fluid boluses, low-flow nasal cannula oxygen and paracetamol. We also complete a septic screen and cover her with broad-spectrum antibiotics. Her … Continue reading
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