Author Archives: TeamHaem

About TeamHaem

Online education and discussion about all things haematological

Case 100 (part C) – the beginning

You are in a GP surgery and are asked to perform a full blood count on a 60 year old male who is awaiting a knee replacement for osteoarthritis. He has a past history of glaucoma, hypertension and a myocardial … Continue reading

Posted in Chronic leukaemia, Lymphoma | Tagged

Case 100 (part B) – summary

Our patient had a mild neutrophilia. Neutrophilia can be seen in: Neonates Infection Especially bacterial (note marrow depletion may occur leading to neutropenia) Inflammation, autoimmune diseases etc. Acute gout Stressed states with high adrenaline e.g. myocardial infarction, exercise, acidosis, eclampsia, … Continue reading

Posted in Laboratory morphology, Myeloproliferative neoplasm, Related to other specialities | Tagged , , , , , , ,

Case 100 (part B) – update

Our patient’s neutrophilia/thrombocytosis is attributed to his chest infection. You advise to get a repeat FBC in one month but he forgets and goes to Spain for some ‘winter sun’. On return he has a repeat FBC: Hb 145g/l (115-165) … Continue reading

Posted in Laboratory morphology, Myeloproliferative neoplasm, Related to other specialities | Tagged , , , , ,

Case 100 (part B) – the beginning

You are at a GP surgery and you see a 59 year old gentleman. He has a past history of colorectal cancer than was operated on two years ago and he never needed chemotherapy. He has hypertension and benign prostatic … Continue reading

Posted in Myeloproliferative neoplasm, Related to other specialities | Tagged , ,

Case 100 (part A) – summary

Our patient had mild neutropenia. Neutropenia has a number of causes and the finidning of neutriopenia should prompt clinical evaluation.   Causes of neutropenia include Sepsis secondary to exhausting neutrophil pool Nutritional deficiency – B12, folate, copper, anorexia Hypersplenism Viral … Continue reading

Posted in Bone marrow failure, Related to other specialities | Tagged ,

Case 100 (part A) – the beginning

We’re going to do a few short cases this week… hope you’re on your toes! You are working in a GP surgery and a 28 year old female comes to see you as she has been feeling fatigued. Further evaluation … Continue reading

Posted in Bone marrow failure, Related to other specialities | Tagged

Case 99 – Summary

Thank you for your contribution in our #TeamHaem case this week. This week we have been looking at Diamond Blackfan anaemia (DBA). This is a rare, genetically and clinically heterogeneous, inherited red cell aplasia. It is one of the Inherited … Continue reading

Posted in Anaemia, Paediatric haematology | Tagged , , , , , , ,

Case 99 – update 5

Genetic testing on both parents and her brother are carried out and are all negative. Hence this is a de novo mutation of RPL5 in our little girl. You also carry out HLA typing on her and her brother, who … Continue reading

Posted in Anaemia, Paediatric haematology | Tagged , , , , , , ,

Case 99 – update 4

Based on a diagnosis of Diamond Blackfan anaemia, a decision is made to start a regular transfusion programme until she is over 1 year of age to minimise the impact of steroids on her growth. It will also allow her … Continue reading

Posted in Anaemia, Paediatric haematology | Tagged , , , , ,

Case 99 – update 3

A bone marrow biopsy has been carried out: (see below) Aspirate shows erythroid hypoplasia but no dysplastic features. Cellularity is normal and megakaryocyte & granulocyte lineages are normal. For interest, also see Trephine IHC with Glycophorin-C staining – demonstrating reduced … Continue reading

Posted in Anaemia, Laboratory morphology, Paediatric haematology | Tagged , , , ,

Case 99 – update 2

A blood film has been looked at, no specific findings are noted except for anaemia and occasional spherocytes. There are no red cell fragments, no dysplastic features and no primitive cells. EMA & G6PD are in progress. Parvovirus B19 serology … Continue reading

Posted in Anaemia, Paediatric haematology | Tagged , ,

Case 99 – update 1

You call Mum and repeat the baby’s blood count urgently. Her repeat bloods show: Hb 63g/L Platelet 506 x 10^9 MCV 99.9fL, WBC 9.36x 10^9 Neutrophil 3.46 x 10^9 You explain to Mum that her baby is anaemic and you … Continue reading

Posted in Anaemia, Paediatric haematology | Tagged ,

Case 99 – the beginning

Welcome to our new #TeamHaem case. You are working in General practice. You see a 9 month old baby girl in the morning. Her mother tells you that in recent weeks she has needed more naps and has not been … Continue reading

Posted in Anaemia, Paediatric haematology | Tagged ,

Case 98 – summary

Following several obinutuzumab reactions, which resulted in overnight hospital admissions, our patient decided he did not wish to continue with obinutuzumab. He continues on chlorambucil monotherapy and has tolerated it reasonably well and his disease appears to be responding. Thankyou … Continue reading

Posted in Chronic leukaemia | Tagged , , , , ,

Case 98 – part 2 – update 1

We have confirmed progression in our patient’s CLL. There is no evidence of haemolysis. He has a pmh of HTN, diabetes, mild copd and osteoarthritis which limits his mobility. He has an ecog of 2 (was 1 prior to the … Continue reading

Posted in Chronic leukaemia | Tagged , , , ,

Case 98 – part 2 – the beginning

Thankyou for your help with part 1. Here is the second part of this weeks case. You are in the haematology clinic and are seeing an 82 year old gentleman who was diagnosed with CLL 10 years ago. He has … Continue reading

Posted in Chronic leukaemia | Tagged , , , ,

Case 98 – part 1 – update 3

Our patient has been started on venetoclax and has had an excellent response. Following discussions with our patient and referral to the transplant team he has decided to go ahead with a sibling allo SCT. What considerations are there for … Continue reading

Posted in Chronic leukaemia | Tagged , , , ,

Case 98 – part 1 – update 2

Our patient has been diagnosed with CLL and has been found to have deletion 17p on cytogenetics. He has now been on ibrutinib for 15 months. He has tolerated it very well and did get an improvement in his Hb … Continue reading

Posted in Chronic leukaemia | Tagged , ,

Case 98 – part 1 – update 1

We have found our patient has a lymphocytosis with mild anaemia and mild thrombocytopenia. Blood film show lymphocytosis with mature lymphocytes and smear cells. We have some flow results. What do these show? What is our diagnosis? Would you like … Continue reading

Posted in Chronic leukaemia, Laboratory morphology | Tagged , ,

Case 98 – part 1 – the beginning

Welcome to our new case! We will do 2 short cases this week. In our first case we start in general practice. A 42 year old patient has come to see you as he has been training for a marathon … Continue reading

Posted in Chronic leukaemia