Category Archives: Acquired bleeding

Case 81 – summary

Thank you for all the contributions to the case this week. The case We looked at a case of a 58 year gentleman who had an incidental finding of thrombocytopenia, whilst on apixaban therapy. Immediate intervention was required to stop … Continue reading

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Case 81 – update 2

Thankfully the bleeding resolves and no surgical intervention is required The platelet count responds to IVIG, and dexamethasone 40mg given for four days. Any further investigations required?   2 week s following commencement of steroids the platelet count has fallen … Continue reading

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Case 81 – update 1

Our followers have come up with a very comprehensive list of investigations! Our advice/investigation included stopping apixaban Checking Fbc ? Any other abnormalities/previous FBC/ clot in sample  coagulation.  Prolonged PT, normal aptt and fibrinogen renal and liver function HIV, hepatitis … Continue reading

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Case 81 – the beginning

A 58 year old gentlemen has routine bloods taken at the GP surgery.  He is noted to have a platelet count of 38. His doctor rings you as the haematology registrar for advise as he is on apixaban for treatment … Continue reading

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Case 74 – summary

Thankyou for your input this week!This week we had a look at a few abnormalities that can be seen on coagulation screens in a pre procedure setting. The first thing to say is there is no replacement for a good … Continue reading

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Case 74 – part 3

We have our 3rd and final case of the week! A 40 year old man who has a vasculitis ,who has been requiring plasma exchange, needs to have a new line put in for exchange. The renal team are concerned … Continue reading

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Case 74 – part 2

So our second case starts with a phone call from the anaesthetic consultant in the pre op clinic. He has a 20 year old man that needs a wide excision of a suspicious mole on his back.  He has been … Continue reading

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Case 74 – part 1

Welcome to our new teamhaem cases!This week we will run through some short cases with pre operative coagulation screen abnormalities! Our first patient is a 25 year old male who has been admitted to the surgical assessment unit with abdominal … Continue reading

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Case 69 – part 2 – summary

This patient has a medical emergency. She has pancytopenia with evidence of bleeding. There are abnormal promyelocytes and faggot cells (below) which are indicative of acute promyelocytic leukaemia. Acute promyelocytic leukaemia is a subtype of acute myeloid leukaemia characterised by … Continue reading

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Case 69 – part 2 – the beginning

A 21 year old female presents with epistaxis and bleeding gums and the following blood count: Hb 69g/L Platelets 27×10*9/L WCC 12×10*9/L     Questions What is your immediate management? What tests would you like to perform?   Please reply … Continue reading

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Case 61 – summary

Thank you for all your help this week! This week we looked at a case of childhood ITP.  Our patient presented with easy bruising over a 3 week period, and had had a minor urti the previous month. The patient … Continue reading

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Case 61 – update 2

So time for another update! Our patient has been started on oral iron for a iron deficiency anaemia. Given that she only has some bruising and a slight petechial rash the decision has been made to monitor her, but not … Continue reading

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Case 61 – update 1

What have we found out so far? We have a 15 year old girl who has presented with a few week history of easy bruising.  Blood tests have shows a microcytic anaemia with ferritin of 5 and a thrombocytopenia with … Continue reading

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Case 61 – the beginning

Welcome to our new case!This week we start in a gp practice. A 15 year old girl has attended with her mum as she has had problems with easy bruising. She has no other pmh. What would you like to … Continue reading

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Case 53 – summary

Lauren is a 34 year old woman with a postpartum acquired haemophilia. The presentation and diagnosis of this disorder has been discussed in the previous posts; the management is what concerns us at this point. The traditional approach to the … Continue reading

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Case 53 – update 2

Lauren, 34 had a baby 4 months ago and recently consulted her GP with marked easy bruising. Her GP did some blood tests which revealed a prolonged APTT at 69 seconds. The lab did extra tests to establish than rather … Continue reading

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Case 53 – update 1

Yesterday we met Lauren, a 34 year old who went to see her GP with easy bruising. She felt this was a new problem, although she mentioned her sister bruised easily. We explored this a little further. Her sister had … Continue reading

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Case 53 – the beginning

Welcome to the new case for the week. Please read the case, consider the questions posed and share your thoughts via twitter using #teamhaem @teamhaem. Lauren is a 34 year old woman who contacted her GP when she developed some … Continue reading

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Case 35 – summary

Thank you for all of your comments this week! This week we took a walk through acquired factor VIII inhibitors. Acquired haemophilia A is a rare disorder with an incidence of around 1.5 per 1 million per year. There can … Continue reading

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Case 35 – update 2

We have diagnosed our patient with acquired haemophilia A. They have also had a CT scan which is highly suspicious of a caecal cancer. Given the acquired haemophilia it was felt unsafe to proceed with invasive investigations for the caecal … Continue reading

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