Category Archives: Bone marrow failure

Case 100 (part A) – summary

Our patient had mild neutropenia. Neutropenia has a number of causes and the finidning of neutriopenia should prompt clinical evaluation.   Causes of neutropenia include Sepsis secondary to exhausting neutrophil pool Nutritional deficiency – B12, folate, copper, anorexia Hypersplenism Viral … Continue reading

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Case 100 (part A) – the beginning

We’re going to do a few short cases this week… hope you’re on your toes! You are working in a GP surgery and a 28 year old female comes to see you as she has been feeling fatigued. Further evaluation … Continue reading

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Case 96 – summary

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

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Case 96 – update 4

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

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Case 96 – update 3

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

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Case 96 – update 2

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

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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 77 – summary

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

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Case 77 – update 2

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?

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Case 77 – update 1

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

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Case 77 – the beginning

  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

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Case 62 – summary

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

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Case 62 – part A – update

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

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Case 62 – part A

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

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Case 46 – #UnofficialCSIM2 summary

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

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Case 46 – #UnofficialCSIM2: Update 2

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

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Case 46 – #UnofficialCSIM2 Update 1

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

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