Category Archives: Acquired bleeding

Case 92 – summary

Thanks for your help with the cases. This week we have looked at three different scenarios regarding bleeding or bruising presenting in the paediatric population. The cases although different have some common themes: Coagulation testing in paediatrics is challenging for … Continue reading

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Case 92- update part C

We have a 7 year old boy who has presented with bruises over abdomen and one on his ear. Social services have been contacted as there is concern this may be an NAI. The boy is otherwise well has no … Continue reading

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Case 92 – part C

Thanks for your help with case 2 the patient has been diagnosed with Ehlers Danlos and will have an echo arranged to check for any cardiac problems. You now receive a call from the local district general hospital regarding a … Continue reading

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Case 92 – part B

Thanks for your help with case 1 the baby is improving. The following morning you as the Haematology registrar have been referred a 5 year old girl who presented due to parental concern with easy bruising. The bruising was noted … Continue reading

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Case 92 – update part A

Thanks for your help so far An 8 week old baby boy born at 40+2 by Normal vaginal delivery has a CT that confirms a subdural haemorrhage. Results: (With age adjusted reference ranges) FBC – Hb 120 (Low) MCV 120 … Continue reading

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Case 92 – the beginning

This week we will be looking at investigation of bleeding and bruising in the paediatric setting with three short cases. Case 1 An 8 week old baby boy born at 40+2 by Normal vaginal delivery presents with a reduced consciousness … Continue reading

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Case 84 – summary

Thank you for all your help with this weeks case! This week we looked at a case of a patient with type 1 Gaucher’s disease . She was found to be mildly anaemia with a mild thrombocytopenia. A CT scan … Continue reading

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Case 84 – update 2

So we have the results of our patient’s bone marrow and it looks to be consistent with Gaucher’s disease! Our patient has a raised serum ACE and ferritin which is typical of Gaucher’s disease. Our bone marrow shows the typical … Continue reading

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Case 84 – update 1

So we have an update: We have found our patient is thrombocytopenic, and has a mild normocytic anaemia. Our patient has been slightly tired for a year or so, but still manages to do her demanding job as a PE … Continue reading

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Case 84 – the beginning

Welcome to our new case! We start in the GP surgery with a 21 year old woman. She has been feeling tired for a while so has come to get checked. Your colleague did some bloods on the previous visit … Continue reading

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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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