Category Archives: Acute leukaemia

Case 15 – summary

Paediatric ALL In this case, our child presented with a petechial rash.  This can present with a number of different diagnosis therefore a wide differential needs to be formed.  This includes: HSP – Usually a classical distribution of purpura, bruising … Continue reading

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Case 15 – update 5

Bone marrow aspirate confirms your suspicion.  Blast count >60%. Flow cytometry results: CD2 – 12% CD 3-8% CD7 – 12% CD10-86% CD13-2% CD19-60% CD33-1% CD34-71% CD64-2% hla-dr-76% TDT- 47% cd79a- 87% What would these markers suggest? In the UK which … Continue reading

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Case 15 – update 4

As suggested the blood film is suspicious of leukaemia.  You obviously at admit the child for further investigation.  You recognise the risk of tumour lysis. You decide to go ahead and perform a bone marrow under sedation. What other investigations/examinations … Continue reading

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Case 15 – update 3

You had a right to be worried!  This is what you find on the peripheral blood smear.  What can you conclude from this small section of film.  What would you do now?

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Case 15 – update 2

The FBC is ordered that day.  One of the laboratory staff calls the GP with the results. Hb 91 g./l WCC 5.6 x10*9 neut 1.3×10*9 plt 7 x 10*9 what is your differential now? Concerns for this patient? Further investigations

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Case 15 – update 1

Can you describe the rash? On further questioning – the patient has not had a fever and there is no arthalgia. Obviously the GPs first concern is meningitis, however on review there are no signs of meningism. His mother thinks … Continue reading

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Case 15 – the beginning

A young boy presents to his GP with his mother.  She had noticed a rash on his lower limbs. How would you assess this patient? What parts of the history do you need to explore further? What potential investigations would … Continue reading

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Case 5 – summary

We have established that our patient is profoundly septic and requires quick, effective resuscitation, which should include consultation with our ITU colleagues – a young patient who is decompensating is a particular worry as it is suggestive of how shocked … Continue reading

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Case 5 – update 1

The differential diagnosis is broad with such little information (we reallyneed that white cell differential don’t we?). It would include: Acute sepsis with DIC causing thrombocytopenia (although v anaemic for this alone) Acute leukaemia (lymphoblastic or myeloid – we haven’t … Continue reading

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Case 5 – the beginning

You are working night shifts on A&E/MAU in a rural DGH. A 29-year-old man presents via A&E with a three-week history of cough and fatigue. On examination you note significant pallor and a petechial rash. His tonsils are enlarged and … Continue reading

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