Category Archives: Paediatric haematology

Case 63 – the beginning

You are a general practitioner and are reviewing a four year old boy. His mother is worried that he is looking rather pale and has been unusually tired and off his food. He has a sore throat and occasional fever over … Continue reading

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Case 60 – summary

Panel: In this case we interpreted an antibody panel to establish this lady was A RhD positive and had an anti K antibody. When a possible antibody is detected it is important to phenotype the patient’s cell for the corresponding … Continue reading

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Case 60 – update 3

The IUT thankfully was performed without complication and the fetal medicine team repeated the IUT two weeks later and the delivery is then arranged. When planning for delivery what bloods should be taken from the cord sample? What are the … Continue reading

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Case 60 – update 2

The patient has being having regular antibody titres every four weeks and her titre remains 1 in 8. Her weekly MCA dopplers unfortunately shown at 26 weeks her MCA velocity has increased >  1.5 multiples of median suggestive of fetal … Continue reading

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Case 60 – update 1

The lady is Group A positive and has an Anti K antibody detected.The lab performed phenotyping on the maternal sample and she is K negative. She has never been pregnant before. She has no history of IV drug abuse. She … Continue reading

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Case 60 – the beginning

A 36 year old lady attends her antenatal booking appointment and has routine bloods taken including samples for blood grouping and antibody screen. Her Antibody panel and blood group screen is as follows: Please assume auto control negative and other … Continue reading

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Case 31 part 4 – the beginning

Here’s the next installment in our series of short cases. This was a film from a nine year old post haematopoietic stem cell transplant for relapsed AML. The patient was one month post transplant with no evidence of AML but still … Continue reading

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Case 31 part 3 – summary

Some really helpful points from the team (#teamhaem on Twitter). This child presented to the emergency department with severe burns after an accident with boiling water. Phlebotomy was rather difficult, leading to rather poor sampling. Paediatric sampling can be difficult … Continue reading

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Case 31 part 3 – update 1

Here’s the full blood count: Hb 110g/L MCV 82fL PLT 121×10*9/L WCC 11.9×10*9/L with neutrophilia The child is ill and has been brought in as an emergency. She is three years old and had a normal blood count a year … Continue reading

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Case 31 part 3 – the beginning

This was put in the slide tray by one of the biomedical scientists: It is a child – 3 years old. Questions: What do you see? Can you guess what’s going on? What further basic tests would you use at … Continue reading

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Case 30 – summary

We have established that our newborn baby with an intracranial haemorrhage has a low platelet count and have debated the likely cause for this. The list of differentials include: Maternal ITP  (Immune thrombocytopenic purpura: autoimmune destruction of platelets) which can … Continue reading

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Case 30 – update 1

So, we have a neonate with an intracranial haemorrhage, diagnosed after birth due to decreased responsiveness. You had a number of questions for mum and suggestions for tests, including: HISTORY: Medications taken during pregnancy:     only folic acid. Unexplained bleeding in … Continue reading

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Case 30 – the beginning

And we don’t mean we’ve only just entered our 4th decade (we wish!) but that we are now on to our 3oth case. So far we’ve covered a massive range of topics, from common conditions to the truly obscure, neonatal medicine … Continue reading

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Our Second Christmas Cracker: Summary

The first clinical information we gave you is this blood film: You all felt that this film was very worrying and pointed out the numerous blasts, megakarytocyte fragments and abnormal nucleated erythrocytes. When we revealed that this was a newborn … Continue reading

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Our second Christmas Cracker!

So here is our last mini-Christmas case. Have a look at this film: What is going on? Answers on a hashtag (#teamhaem) – all ideas welcome! Please reply on Twitter and always include #teamhaem to allow others to follow your … Continue reading

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First Christmas case: summary

This case started with this film: We all agreed there were leukoerythroblastic changes with tear drop cells and basophilic stippling. These changes might be seen in myelofibrosis or metastatic cancer (although basophilic stippling would be unusual). They might also fit … Continue reading

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A couple of Christmas Quickies!

Welcome to #teamhaem! The rules are simple… we post a case on this site and then people comment on Twitter by replying to @teamhaem and using #teamhaem so everyone else can follow the conversation. Join in! It’s nearly Christmas: PHOTO … Continue reading

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Case 15 – summary

Paediatric ALL In this case, our child presented with a petechial rash.  This can present with a number of different diagnosis therefore a wide differential needs to be formed.  This includes: HSP – Usually a classical distribution of purpura, bruising … Continue reading

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Case 15 – update 5

Bone marrow aspirate confirms your suspicion.  Blast count >60%. Flow cytometry results: CD2 – 12% CD 3-8% CD7 – 12% CD10-86% CD13-2% CD19-60% CD33-1% CD34-71% CD64-2% hla-dr-76% TDT- 47% cd79a- 87% What would these markers suggest? In the UK which … Continue reading

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Case 15 – update 4

As suggested the blood film is suspicious of leukaemia.  You obviously at admit the child for further investigation.  You recognise the risk of tumour lysis. You decide to go ahead and perform a bone marrow under sedation. What other investigations/examinations … Continue reading

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