Author Archives: TeamHaem

This is a case of a 3 month old infant girl presenting with evidence of haemolysis. Blood film showed irregularly contracted cells, target cells and polychromasia.  The reticulocyte count was raised and direct antibody test (DAT) was negative. This is … Continue reading →

You ask the paediatrician about the baby’s history and discover: she has never had a blood tranfusion mum does not have an allogenic antibody there is no known family history of haemolysis there are signs of jaundice Further tests show … Continue reading →

You review a peripheral blood film on the sample (shown below).  What is your differential diagnosis?  What questions to you want to ask the paediatrician?

You’re the oncall haematology registrar and a worried paediatrician rings you about a new patient. Baby A is female infant of 3 months of age.  She has just been brought to accident and emergency by her mother who is concerned … Continue reading →

This week we discussed a case of a young gentleman with pancytopenia. Initial investigations for the cause of pancytopenia were undertaken and these included Repeat FBC Blood film Reticulocyte count Haematinics Liver function Viral studies- cmv, hepatitis, HIV, parvo, hepatitis, … Continue reading →

Bone marrow trephine shows a hypocellular trephine throughout the specimen, supporting your suspicion of aplastic anaemia. There are no dysplastic features present There is no evidence of a PNH clone. How would you classify this patient? What are your immediate … Continue reading →

So far our investigations have shown: Normal haematinics Negative viral screen Negative autoimmune screen Blood film – no blasts/no dysplasia. Anisopoikilocytosis Normal LDH Negative abdominal ultrasound Reticulocytopenia Patient has no significant past medical history and is not taking any regular … Continue reading →

31 year old man attends GP feeling tired. Bloods show HB 65 Platelets 45 WCC 1.2 What further test would you advise? Immediate management?? Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow … Continue reading →

Thank you for everyone’s involvement in the case this week. We discussed a 56 year old man who presented with an acute stroke. This was managed with oral aspirin as his NIHSS score was low at 3 and he presented … Continue reading →

Thank you for everyone’s contributions. Due to his history of renal disease and renal transplant it is important that we consider these as potential secondary causes of polycythaemia. However, taking a thorough history and review of previous blood results has … Continue reading →

Thank you for everyone’s contributions so far! It has been noted that our patient who presented with an ischaemic stroke has a raised HCT and you have mentioned that we need to ensure this is an absolute polycythaemia and if … Continue reading →

Thanks for everyone’s contributions so far. Our 56 year old man was commenced on aspirin by the acute stroke team. He was not suitable for thrombolysis (presented later than 4.5hours of onset of symptoms) and it was felt thrombectomy was … Continue reading →

A 56 year old man presents with left sided arm weakness and slurred speech. His symptoms started 6 hours prior to presentation. He has a significant past medical history of a renal transplant 6 months ago. A CT confirms a … Continue reading →

Our patient presented with MAHA, thrombocytopenia and neurological symptoms which prompted further investigations and confirmation of TTP. Teamhaem have covered TTP previously in case 7, with a different clinical scenario. Therefore the majority of this summary is taken from the … Continue reading →

Our patient improves clinically with PEX/steroids/rituximab. Unfortunately she also suffers a miscarriage. What is your ongoing treatment plan? How would you council her for future pregnancies? Would you offer any treatment pre.conceptually?

TTP is confirmed by ADAMTS13 level of 2%. What further information would be useful and why? Plasma exchange was initiated promptly along with methylprednisone. The patient has had 1.5 plasma volume exchange over the first 3 days of admission. Platelet … Continue reading →

You have reviewed the film and concur with the finishing of marked red cell fragmentation. Thrombocytopenia is also confirmed. You contact the A&E doctor who has reviewed the patient and they confirm as history of a possible seizure prompted hospital … Continue reading →