Category Archives: Anaemia

Case 73 – summary

This week our case involved the care of a 10 year old girl with SCD who had transfered her care to the UK. She presented in outpatient clinic for the first time and we had to determine her management. During … Continue reading

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Case 73 – update 2 

Given the girls high Right MCA doppler at screening the patient started regular transfusion for prevention of CVA. This was initiated due to Adams et al 1998 NEJM paper that showed a 92% risk reduction in patients with high dopplers … Continue reading

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Case 73 – update 1

Thanks for all your suggestions so far. When the patient was seen for the first time the following was established: History: She is now age 10 and moved to the UK from west Africa a few months ago with her … Continue reading

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Case 73 – the beginning

A 10 year old girl attends paediatric outpatient clinic with a history of Sickle Cell Disease. She was born abroad and has just moved to the UK.  What history should you establish?  What should you note on examination? How would … Continue reading

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Case 72- summary

Answers A – hereditary elliptocytosis B – hairy cell leukaemia C – metastatic prostate cancer Case A The first case, we started with something relatively straightforward: This was a blood film of a 21 year old pregnant women who was … Continue reading

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Case 72 – case A

Evening. This week we are going to do some short cases based around morphology.  The aim is for this to be a quick fire week, with lots of interesting pictures!  We would welcome any contribution from our followers too – so tweet in a picture … Continue reading

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Case 68 – Summary

This weeks case was a case of primary warm AIHA in a 36 ear old lady. Haemolysis can seem complex to investigate and treat and there is excellent new BSH guidance ( see references) on the subject of Haemolysis which … Continue reading

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Case 68 – update 1

So far we have found out our 36 year old lady has been tired for a few weeks. She has no history of weight loss or night sweats. She has not lost any weight or noted any lumps or bumps. … Continue reading

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Case 68 – the beginning

A 36 year old lady presents to her GP feeling tired and with reduced exercise tolerance. The GP performs blood tests to investigate.  Hb 67g/l, MCV 100 (normal 77-95), Wcc 4.2, Neu 3,  Plt 160. Blood film: What do the … Continue reading

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Case 67 – part 3 summary

Thankyou for all your help this week. This week we had a quick look at 3 causes for anaemia in children, although there are obviously many more! For our final case this week we had a young boy who had … Continue reading

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Case 67 – part 3

And here we have our 3rd and final case A 4 year old boy who is normally well has been bought to A&E by his dad. He has been unwell for the last few days, and dad thinks he is … Continue reading

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Case 67 – part 2 summary

We have found that our patient has PCH. PCH is a form of auto immune haemolytic anaemia which will usually present in young children. It is caused by a biphasic antibody with will usually target the P antigen on red … Continue reading

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Case 67 – part 2

Here we have our second case! A 5 year girl old presents to her A&E with her grandmother. She had been the park today and has now become generally unwell with abdominal pain, back pain, vomiting and feeling shivery. HB … Continue reading

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Case 67 – part 1 summary

So we have found our patient has g6pd deficiency precipitated by eating broad beans. With folic acid and supportive care he made a full recovery. G6pd deficiency is an X linked disorder that results in a deficiency of the enzyme … Continue reading

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Case 67 – part 1

Welcome to our cases this week. This week we will be focusing on children, with 3 short cases. Our first case begins in A&E. We have a 3 year old boy who’s  mum has bought him in because he has … Continue reading

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Case 63 – summary

Thanks to everyone who has taken part in this week’s case. It focused on childhood anaemia and it’s investigations. See a link to our Storify of this week’s case https://storify.com/TeamHaem/case-63-a-pale-child   Childhood anaemia There are a number of causes of anaemia … Continue reading

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Case 63 – update 4

Our four year old appears to have acute parvovirus infection. It commonly causes reduced rd cell production but this is generally only significant in patients with increased red cell destruction, who rely on a very active marrow e.g. inherited and … Continue reading

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Case 63 – update 3

Our four year old has spherocytes on the blood film. These are seen in various types of haemolytic anaemias – mainly autoimmune haemolysis and hereditary spherocytosis. There is a lack of polychromasia reflecting the lack of marrow turnover and linking … Continue reading

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Case 63 – update 2

Our four year old has been having fever and is pale. A blood count showed: Hb 45g/l (115-145g/l) MCV 85fL WCC 12×10*9/l (5-15×10*9/l) with normal white cell differential Platelets 352×10*9/l (150-450×10*9/L) Reticulocytes 5×10*9/l (50-100×10*9/l)   A blood film is requested and … Continue reading

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Case 63 – update 1

We have a pale four year old boy who appears to be generally unwell with occasional fever and sore throat. On examination his observations show a tachycardia of 140bpm and respiratory rate of 35rpm. There is no menginism. There are … Continue reading

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