Category Archives: Acquired bleeding

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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Case 35 – update 1

What have we found out so far? We have a 67 year old gentleman who has presented with a 2 day history of thigh pain and swelling. An u/s has shown an intramuscular haematoma. He was on warfarin for AF … Continue reading

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Case 35 – the beginning

Welcome to our new case that we will see develop over the next week with your help! A 67 year old gentleman presents to his gp with a 2 day history of pain and swelling in his right thigh.  On … Continue reading

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Dermatology short cases: case 3 (answers)

Case Three: Amyloidosis The signs, symptoms and complications of Amyloidosis are legion, so we will not try to summarise the condition here. However the case asked about one particular sign: This, as you all identified, is a characteristic change seen … Continue reading

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Dermatology short cases: case 1

This photo is an example of livedo reticularis: The haematological condition that is associated with livedo reticularis is Antiphospholipid syndrome. APS is also associated with: necrotizing vasculitis thrombophlebitis cutaneous ulceration Necrosis subungual splinter haemorrhages erythematous macules, purpura, ecchymoses painful skin … Continue reading

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Morphology – case 5 (summary)

Thanks for all of your responses. The full blood count of our patient showed Hb 82g/L, PLT 34×10*9/L, WCC 6.2×10*9/L, neuts 0.34×10*9/L. The film showed abnormal leukaemic blast cells which are occasionally bilobed and heavily granulated with stacks of Auer … Continue reading

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Case 14 – summary

The idea behind this case was to look at a relatively common problem, prolonged APTT and recognise how we should be acting upon it. There are a number of causes of a prolonged APTT.  In this case the best approach … Continue reading

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Case 14 – update 4

Factor levels are undertaken – results show a reduced factor VIII levels, however all other factors are within normal range. Von willibrands screen has therefore been requested. Are there any other causes of reduced factor VIII levels in this patient? Consider the … Continue reading

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Case 14 – update 3

So the APTT corrects on mixing, therefore dome of you have suggested possible factor deficiency.  Which factors would you request levels for. The patient is Day 2 of his hospital stay and the nursing staff have witnessed an episode of … Continue reading

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Case 14 – update 2

Repeat coagulation screen confirms a prolonged APTT, with the remainder of the clotting screen being within normal limits. Mixing studies are performed and the APTT corrects.  What does this show? If the APTT did not correct on mixing what would … Continue reading

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Case 14 – update 1

You review the history taken in the medical note.  This was a 65 year old gentleman who had presented with a 3 week history of lethargy, SOB on exertion and had noted some dark stool on occasions.   You note a … Continue reading

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