Category Archives: Paediatric haematology

Case 92 – summary

Thanks for your help with the cases. This week we have looked at three different scenarios regarding bleeding or bruising presenting in the paediatric population. The cases although different have some common themes: Coagulation testing in paediatrics is challenging for … Continue reading

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Case 92- update part C

We have a 7 year old boy who has presented with bruises over abdomen and one on his ear. Social services have been contacted as there is concern this may be an NAI. The boy is otherwise well has no … Continue reading

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Case 92 – part B

Thanks for your help with case 1 the baby is improving. The following morning you as the Haematology registrar have been referred a 5 year old girl who presented due to parental concern with easy bruising. The bruising was noted … Continue reading

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Case 92 – update part A

Thanks for your help so far An 8 week old baby boy born at 40+2 by Normal vaginal delivery has a CT that confirms a subdural haemorrhage. Results: (With age adjusted reference ranges) FBC – Hb 120 (Low) MCV 120 … Continue reading

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Case 92 – the beginning

This week we will be looking at investigation of bleeding and bruising in the paediatric setting with three short cases. Case 1 An 8 week old baby boy born at 40+2 by Normal vaginal delivery presents with a reduced consciousness … Continue reading

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Case 83 – summary

Many thanks to everyone who contributed to our case. This week the case centred on a pregnant female who was an obligate carrier of Haemophillia A (Her Father was affected). She had a factor VIII level of 54%. She was … Continue reading

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Case 83 Рupdate 3 

Our pregnant patient had a factor VIII level of 54%. She is a carrier of intron 22 inversion as predicted from family history.  The free fetal DNA testing confirms she is carrying a male fetus. The patient has decided that … Continue reading

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Case 76 – summary

This case focussed on a newly diagnosed patient with haemophilia A. The patient was three days old and presented non-specifically unwell and feeding poorly. The differential here is wide from sepsis to hypoglycaemia to congenital heart defects and metabolic disorders. … Continue reading

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Case 76 – update 4

Our patient is doing well with recombinant VIII replacement. Monitoring scans reveal shrinking of the haemorrhage. On further questioning his mother suffered bleeding post dental extraction requiring re-packing and menorrhagia along with easy bruising. Haemophilia A is an X linked … Continue reading

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Case 76 – update 3

Our patient is started on recombinant factor VIII replacement and achieves a trough level of 100%. Neurosurgery is not required. Genetic samples are sent to examine the F8 gene to see where the mutation is as this can help investigate … Continue reading

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Case 76 – update 2

Factor assays are back. IX, XI and XII are within normal limits for neonates but VIII is <1%. This confirms the diagnosis of severe haemophilia A.   The child is transferred to the regional haemophilia centre for intensive VIII replacement … Continue reading

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Case 76 – update 1

Our three day old child is admitted unwell and has deranged clotting with a markedly prolonged APTT. The team wanted an ultrasound scan which confirms a small intraparenchymal bleed. Repeat coagulation testing shows: PT 18s (12-14 adult) APTT 92s (30-38 … Continue reading

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Case 76 – the beginning

You are working in the emergency department of a district general hospital. Parents bring a three day old child in for assessment as he has been non-specifically unwell, looking pale and feeding poorly. He was born at term by spontaneous … 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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