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Category Archives: Haemoglobinopathy
Case 86 – part A2
This short case focused on the diagnosis of thalassaemia over iron deficiency. The below factors can help, but there are many overlapping factors and this is more of a guide rather than absolute. Factors that may make this unreliable include … Continue reading
Posted in Anaemia, Haemoglobinopathy, Laboratory morphology
Tagged anaemia, Blood film, haemoglobinopathy, HbEE, HPLC, microcytosis, morphology, thalassaemia
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Case 86 – part A1
Welcome to #TeamHaem. This week we are going to look at some blood film morphology. A 21 year old female student has a full blood count done due to fatigue. Hb 100g/L MCV 74fl MCH 21.7pg Platelets 250×109/l WCC and … Continue reading
Posted in Anaemia, Haemoglobinopathy, Laboratory morphology
Tagged anaemia, Blood film, haemoglobinopathy, HbEE, HPLC, microcytosis, morphology, thalassaemia
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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
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
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
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
Case 50 part 2 – summary
In haematology it is important integrate laboratory investigations to clinical presentations. A blood transfusion was requested in a young patient with macrocytic anaemia with no previous blood count information. The blood film was reviewed rapidly: The diagnosis of a … Continue reading
Case 50 part 2 – the beginning
A 21 year old female presents with chest pain. You are asked to authorise a blood transfusion as she is anaemic. Hb 69g/L (115-160) MCV 111fL (79-98) WCC 12.6×10*9/L (4-11) Neuts 10.6×10*9/L (2-7) PLT 578×10*9/L (150-400) Here is her blood … Continue reading
Case 36 – update 2
Following testing of the father, he is also found to be a carrier of Beta-thalassaemia. The pregnancy continues, and following counselling the family decline any further investigation until the fetus is born. What would be the options for testing prior … Continue reading
Case 36 – update 1
Patients’ blood film looks like this: Ferritin level was also checked : 10 ug/l Family origin questionnaire has been mentioned and should be performed at all antenatal visits. However all women – in both high prevalence and low prevalence areas … Continue reading
Posted in Anaemia, Haemoglobinopathy, Laboratory morphology
Tagged anaemia, Beta-thalassaemia, Blood film, iron deficiency
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Case 36 – the beginning
A 22 year old women has her antenatal booking in bloods taken. Her FBC shows Hb 10.2 g/dl MCV 71 fL (77-95fL) MCH 22 pg (26-33 pg) MCHC 33 g/dl (31-36g/dl) RDW 12.5% (11.5-14.5%) What features may be present on … Continue reading
Posted in Anaemia, Haemoglobinopathy
Tagged anaemia, Beta-thalassaemia, microcytosis, Obstetrics
1 Comment
Case 34 – summary
This was a varied case centered around an unwell patient with sickle cell anaemia post surgery. There were a number of themes to cover in this case reminding us that patients with sickle cell anaemia can be complex and require … Continue reading
Case 34 – update 4
Our patient with sickle cell anaemia has been investigated for a delayed haemolytic transfusion reaction. However, the reticulocyte count was not elevated and the direct antiglobulin test was not positive as would be expected. Similarly there was no new antibody … Continue reading
Case 34 – update 3
Lots of great suggestions via #teamhaem. Patients with sickling disorders need careful attention when operations are being planned. They should be carefully pre-assesed with involvement of haematologists and anaesthetists. Important points include: Respiratory function post op – high risk of … Continue reading
Case 34 – update 2
We have a patient with sickle cell anaemia post op who is now more anaemic. She also has a sickle cell crisis with abdominal pain. She has a rather elevated CRP which may be post op or due to the … Continue reading
Case 34 – update 1
Thanks for all of the great contributions on Twitter via #teamhaem We have initiated basic treatment for patients with a potential sickle cell crisis: Oxygen if hypoxic Hydration Analgesia Keep warm Low threshold for antibiotics Septic screen Our patients investigations show: … Continue reading
