Category Archives: Bone marrow failure

Case 46 – #UnofficialCSIM2 Haematology Week

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.

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Case 28 – summary

Case 28 explored the differential diagnoses to be considered when faced with  a patient with pancytopenia. We worked through a number of differentials during the case – see the previous update. However we concluded that our patient seemed to have … Continue reading

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Case 28 – update 2

We had a busy week this week, but have established a diagnosis of Aplastic Anaemia for our young woman. Please see our latest storify if you are interested in our how our discussion evolved (https://storify.com/TeamHaem/case-28) although I will summarise below: … Continue reading

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Case 28 – update 1

So our young woman is in A&E/ED. We have established the following: She has been a little tired and anorexic lately. She had a sore throat 2 weeks ago and received amoxicillin. She only took the pills for 4 days … Continue reading

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Case 28 – the beginning

A 25 year old woman attends A&E complaining of lethargy and dyspnoea. She denies any cough or sputum and examination and CXR are clear. She has a temperature of 39 and small lymph nodes are palpable throughout the cervical chains … Continue reading

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Case 19 – summary

There are a number of important points to this case. 1) The patient is known to be chronically neutropenic because of myelodysplasia.  Myelodysplasia results in varying degrees of pancytopenia due to a clonal bone marrow malignancy.  Patients are at risk … Continue reading

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Case 19 – update 6

For the start of the case scroll below… or click https://teamhaem.wordpress.com/2014/01/26/case-19-the-beginning/ The team have correctly identified that the patient is having a delayed transfusion reaction.  The fevers she complained of initially may have been due to this but concurrent infection may … Continue reading

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Case 19 – update 5

For the start of the case scroll below… or click https://teamhaem.wordpress.com/2014/01/26/case-19-the-beginning/ So far our patient with chronic neutropenia due to myelodysplasia has been admitted with fevers and anaemia.  She only had a transfusion a matter of days ago, so her anaemia … Continue reading

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Case 19 – update 4

For the start of the case scroll below… or click https://teamhaem.wordpress.com/2014/01/26/case-19-the-beginning/ Our team have come up with some good points. Could a paroxysmal haemoglobinuria clone has occurred causing haemolysis Haemolysis can rarely be associated with myelodysplasia The patient now has symptomatic … Continue reading

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Case 19 – update 3

For the start of the case scroll below… or click https://teamhaem.wordpress.com/2014/01/26/case-19-the-beginning/ Here is a blood film for our patient: Questions: Name three features? What could be the unifying diagnosis? Please reply on Twitter and always include #teamhaem to allow others to … Continue reading

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Case 19 – update 2

For the start of the case see below… or click https://teamhaem.wordpress.com/2014/01/26/case-19-the-beginning/ The patient has been started on first line antibiotics (piparacillin/tazobactam and gentamycin in this hospital) and is stable.  The biochemistry results return: Na 134mmol/L K 4.7mmol/L Cr 75umol/L Urea 7.3mmol/L … Continue reading

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Case 19 – update 1

For the start of the case see below… or click https://teamhaem.wordpress.com/2014/01/26/case-19-the-beginning/ There are a few points which #teamhaem have correctly identified: 1) The patient is usually neutropenic or is at risk of neutropenia; therefore it is important to treat this person … Continue reading

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Case 19 – the beginning

Welcome back to TeamHaem You have a  patient with chronic pancytopenia due to myelodysplasia attending the day unit because of temperatures.  She is 69 years old and has suffered from myelodysplasia for the past 7 years.  Myelodysplasia is a malignant … Continue reading

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Morphology week – summary

Slide 1 Answer:  Bernard Soulier syndrome, bleeding disorder characterized by thrombocytopenia and large platelets.  Autosomal recessive inheritance.  Presentation consistent with low or dysfunctional platelets and include easy bruising, nosebleeds, mucosal bleeding, menorrhagia, and, occasionally, GI bleeding. Slide 2 Answer:  Hairy cell leukaemia. … Continue reading

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Morphology week – case 5

? diagnosis further investigations?

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