Category Archives: Platelet disorders

Case 81 – summary

Thank you for all the contributions to the case this week. The case We looked at a case of a 58 year gentleman who had an incidental finding of thrombocytopenia, whilst on apixaban therapy. Immediate intervention was required to stop … Continue reading

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Case 81 – update 2

Thankfully the bleeding resolves and no surgical intervention is required The platelet count responds to IVIG, and dexamethasone 40mg given for four days. Any further investigations required?   2 week s following commencement of steroids the platelet count has fallen … Continue reading

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Case 81 – update 1

Our followers have come up with a very comprehensive list of investigations! Our advice/investigation included stopping apixaban Checking Fbc ? Any other abnormalities/previous FBC/ clot in sample  coagulation.  Prolonged PT, normal aptt and fibrinogen renal and liver function HIV, hepatitis … Continue reading

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Case 81 – the beginning

A 58 year old gentlemen has routine bloods taken at the GP surgery.  He is noted to have a platelet count of 38. His doctor rings you as the haematology registrar for advise as he is on apixaban for treatment … Continue reading

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Case 61 – summary

Thank you for all your help this week! This week we looked at a case of childhood ITP.  Our patient presented with easy bruising over a 3 week period, and had had a minor urti the previous month. The patient … Continue reading

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Case 61 – update 2

So time for another update! Our patient has been started on oral iron for a iron deficiency anaemia. Given that she only has some bruising and a slight petechial rash the decision has been made to monitor her, but not … Continue reading

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Case 61 – update 1

What have we found out so far? We have a 15 year old girl who has presented with a few week history of easy bruising.  Blood tests have shows a microcytic anaemia with ferritin of 5 and a thrombocytopenia with … Continue reading

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Case 61 – the beginning

Welcome to our new case!This week we start in a gp practice. A 15 year old girl has attended with her mum as she has had problems with easy bruising. She has no other pmh. What would you like to … Continue reading

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Case 45 – summary

This case dealt with two relatively common problems. We had a pregnant patient who was both iron deficient and thrombocytopenic. 1) Iron deficiency in pregnancy Anaemia in pregnancy is fairly common. There can be a 45% increase in plasma volume which will … Continue reading

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Case 45 – update 4

The iron deficiency anaemia has resolved. A ferritin was checked (although not technically necessary) and it was reassuringly well within the normal range indicating adequate iron stores. Now the issue is she is thrombocytopenic in week 36: Hb 118g/L MCV … Continue reading

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Case 45 – update 3

The blood film in the earlier post has been reported as : “Microcytic anaemia with no specific features of iron deficiency or haemoglobinopathy; suggest check iron status” The HPLC shows no variant haemoglobin and the HbA2 is within normal limits … Continue reading

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Case 45 – update 2

So far we have a pregnant lady who is feeling tired and has a microcytic anaemia. It is likely she has iron deficiency. Her family origin questionnaire is done as part of antenatal screening and she states that she is … Continue reading

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Case 45 – update 1

So far we have a women who is 11 weeks pregnant and feeling tired and out of sorts. She has a microcytic anaemia and a borderline platelet count. Firstly let’s think about the anaemia. The two most common causes of … Continue reading

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Case 45 – the beginning

You are in a GP surgery as the GP registrar. A 24 year old female complains of feeling tired. She is eleven weeks pregnant and was due her ‘booking visit’ by the midwife in a one week’s time. She has … Continue reading

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Case 32 – summary

Our patient has now been on argatroban for 5 days and his plt count has risen to 115. He has no evidence of bleeding and no thrombosis. He continues to improve post operatively and is starting to mobilise. Given that … Continue reading

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Case 32 – update 2

Our patient has been found to be HIT positive on the ELISA. He initially had a HIT screen test with a rapid gel agglutination assay for antibodies directed against the PF4/heparin complexes which is positive. This test has a good … Continue reading

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Case 32 – update 1

So what have we found out so far? We have a 40 year old man, who had one episode of ITP as a child, with dilated cardiomyopathy who is now 7 days post LVAD with plt of 30 and falling. … Continue reading

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Case 32 – the beginning

Welcome to our new case! Another haematology problem that we will need everyone’s expertise to unravel. This week we are dealing with matters of the heart! A 40 year old man with dilated cardiomyopathy, who is awaiting a heart transplant, … Continue reading

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Case 31 part 4 – summary

Thanks for all of your comments. The film had numerous red cell changes including fragmentation (schistocytes), Howell Jolly bodies, accanthocytes, spherocytes. There was also thrombocytopenia and Howell-Jolly like inclusions in the neutrophils. The most significant finding are the red cell fragmentation. … Continue reading

Posted in Anaemia, Laboratory morphology, Platelet disorders, Transplant | Tagged | 2 Comments

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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