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Category Archives: Paediatric haematology
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
Posted in Acquired bleeding, Inherited bleeding, Paediatric haematology
Tagged bleeding, coagulation, intercranial haemorrhage, neonatal, paediatrics, vitamin K
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
Posted in Inherited bleeding, Paediatric haematology
Tagged 50:50 Mix, bleeding, FFP, genetics, haemophilia, haemophilia A, inhibitor, neonatal, paediatrics, Prolonged APTT
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
Posted in Inherited bleeding, Paediatric haematology
Tagged 50:50 Mix, bleeding, FFP, genetics, haemophilia, haemophilia A, inhibitor, neonatal, paediatrics, Prolonged APTT
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
Posted in Inherited bleeding, Paediatric haematology
Tagged 50:50 Mix, bleeding, FFP, genetics, haemophilia, haemophilia A, inhibitor, neonatal, paediatrics, Prolonged APTT
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
Posted in Inherited bleeding, Paediatric haematology
Tagged 50:50 Mix, bleeding, FFP, genetics, haemophilia, haemophilia A, neonatal, paediatrics, Prolonged APTT
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
Posted in Inherited bleeding, Paediatric haematology
Tagged 50:50 Mix, bleeding, FFP, haemophilia, haemophilia A, neonatal, paediatrics, Prolonged APTT
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
Posted in Inherited bleeding, Paediatric haematology
Tagged neonatal, paediatrics, Prolonged APTT
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
Posted in Anaemia, Paediatric haematology
Tagged haemolysis, hereditary spherocytosis, paediatrics, parvovirus, reticulocytopenia, Spherocytosis
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
Posted in Anaemia, Paediatric haematology
Tagged haemolysis, hereditary spherocytosis, paediatrics, parvovirus, reticulocytopenia, Spherocytosis
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
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
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
Posted in Anaemia, Paediatric haematology
Tagged G6PD deficiency, haemolysis, intravascular haemolysis, paediatrics
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
Posted in Anaemia, Paediatric haematology
Tagged G6PD deficiency, haemolysis, intravascular haemolysis, paediatrics
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
Case 63 – update 4
Our four year old appears to have acute parvovirus infection. It commonly causes reduced rd cell production but this is generally only significant in patients with increased red cell destruction, who rely on a very active marrow e.g. inherited and … Continue reading
Case 63 – update 3
Our four year old has spherocytes on the blood film. These are seen in various types of haemolytic anaemias – mainly autoimmune haemolysis and hereditary spherocytosis. There is a lack of polychromasia reflecting the lack of marrow turnover and linking … Continue reading
Posted in Anaemia, Paediatric haematology
Tagged anaemia, Blood film, morphology, normocytic anaemia, paediatrics, parvovirus, reticulocytopenia, Spherocytosis, viral infection
Case 63 – update 2
Our four year old has been having fever and is pale. A blood count showed: Hb 45g/l (115-145g/l) MCV 85fL WCC 12×10*9/l (5-15×10*9/l) with normal white cell differential Platelets 352×10*9/l (150-450×10*9/L) Reticulocytes 5×10*9/l (50-100×10*9/l) A blood film is requested and … Continue reading
Posted in Anaemia, Paediatric haematology
Tagged anaemia, Blood film, Fever, morphology, normocytic anaemia, paediatrics, reticulocytopenia, Spherocytosis, viral infection
Case 63 – update 1
We have a pale four year old boy who appears to be generally unwell with occasional fever and sore throat. On examination his observations show a tachycardia of 140bpm and respiratory rate of 35rpm. There is no menginism. There are … Continue reading
Posted in Anaemia, Paediatric haematology
Tagged anaemia, blood transfusion, Fever, normocytic anaemia, paediatrics, viral infection
