Category Archives: Bone marrow failure
Thank you for participating in our case this week. This week we have been looking at a case of JMML (Juvenile myelomonocytic leukaemia), which is a rare clonal haematopoietic disorder of childhood, characterised by the proliferation of granulocytic and monocytic … Continue reading
The haematology team has now taken over his care. Bone marrow aspirate has demonstrated a hypercellular marrow with left shift, and there are increased myeloid and monocyte lineages. Blast count is about 4%. There is occasional evidence of haemophagocytosis and … Continue reading
The blood film has been reported: – leukocytosis with neutrophilia and monocytosis, there is left shift and toxic granulation and vacuolation. Occasional primitive cells ~ 2%. No nucleated RBCs. The appearances might be reactive/infection related, and infection as well as … Continue reading
An USS abdomen has been performed which confirms mild hepato-splenomegaly. CXR was reported as normal. Faecal elastase, TTG, TFTs, ILGF1 all normal. You phone the haematology registrar to look at the blood film in view of the abnormal FBC. Questions: … Continue reading
Case 77 Summary Thanks to everyone who contributed to the case this week. Our case started with a blood film to test our morphology skills. We picked up that the blood film showed: Dysplastic neutrophils Blasts NRBCs Tear … Continue reading
Bone marrow results: 13% blasts evidence of dysplasia in the erythroid and myeloid cell lines Cytogenetics:trisomy 8 How would you classify this patient? What would be your approach to management?
So far, we have a 54 year old male who is pancytopenic. He demonstrates features of myelodysplasia on blood film. we have not had any clinical details, but most have suggested admission which does not seem unreasonable given the patients … Continue reading
Let’s start this case with a blood film. Can you describe the findings on the film? What information would you like as the registrar reviewing the film? Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem … Continue reading
Haematological emergencies Patient A presented with an episode of neutropenic sepsis. As a junior you should be suspicious of someone being neutropenic if they have had recent chemotherapy (usually within the past 1-2 weeks). Reviewing patients previous blood results … Continue reading
Patient A has been with us for 48hrs. He stabilised with the prompt treatment delivered on admission, but has spiked a temp in the last 12 hours. His hickman line is still in situ. He was anaemic on admission … Continue reading
This week our aim is to develop a few short cases based on emergencies in haematology. The case will be mostly aimed at junior doctors and medical students, timing with the transition of juniors in UK to new rotations this … Continue reading
Thank you to those of you who joined in with this case; we hope it was a useful and enjoyable way to learn. We covered a few important topics during the case: the differential for a macrocytic anaemia Investigating macrocytosis … Continue reading
Mr Ordie was referred to Haematology clinic after his initial investigations were unremarkable. Bhy this point his Hb was 85g/l with an MCV of 114fl, platelets of 107. A bone marrow biopsy was performed, which showed: . IMAGE: dysplastic red … Continue reading
Thanks for all your hard work so far. We’ve established that Mr Ordie has a macrocytic anaemia with normal thyroid function tests, normal B12 and folate and no significant alcohol history. He takes methotrexate and folic acid for rheumatoid arthritis. Methotrexate … Continue reading
NB To our lonstanding teamhaemers: this week’s case is for medical students. Whilst we may call on some of the usual team to help us out, for now please observe without speaking! Thanks in anticipation.