Category Archives: Platelet disorders

Case 100 (part D) – summary

Posted on 05/10/2018 by

The patient had mild thrombocytopenia and has suffered epistaxis. Epistaxis is relatively common and therefore structural causes should also be looked into. This is especially so if the nose bleeds are unilateral. There is a wide differential of why someone … Continue reading →

Posted in Inherited bleeding, Laboratory morphology, Paediatric haematology, Platelet disorders | Tagged , , , , , , , ,

Case 100 (part D) – update

Posted on 05/10/2018 by

You repeat the FBC and it shows similar results Hb 141g/l (130-180) MCV 89fl (82-98) WCC 7.5×109/l (4-11) Neutrophils 4.7×109/l (1.7-7.5) Lymphocytes 2.1×109/l  (1.5-4.5) Platelets 70×109/l (150-450) Coagulation screen – normal U&E/LFT – normal Blood film: Questions What is the … Continue reading →

Posted in Inherited bleeding, Laboratory morphology, Paediatric haematology, Platelet disorders | Tagged , , , , , ,

Case 100 (part D) – the beginning

Posted on 04/10/2018 by

You are a GP evaluating a 12 year old boy with persistent nose bleeds. He otherwise feels well with no past medical history. He is on no medications. FBC shows: Hb 140g/l (130-180) MCV 90fl (82-98) WCC 8.5×109/l (4-11) Neutrophils … Continue reading →

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Case 86 – part C2

Posted on 16/11/2017 by

Thanks for your help with this short case. We examined this blood film of an unwell female: The most striking abnormality is red cell fragmentation. This can be seen in: AIHA/Evans’ syndrome DIC Pregnancy-associated (HELLP, pre-eclampsia, malignant hypertension, fatty liver of … Continue reading →

Posted in Laboratory morphology, Platelet disorders, Thrombosis, Transfusion | Tagged , , , , ,

Case 81 – summary

Posted on 31/07/2017 by

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 →

Posted in Acquired bleeding, Anticoagulation, Platelet disorders | Tagged , , ,

Case 81 – update 2

Posted on 26/07/2017 by

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

Posted on 24/07/2017 by

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 →

Posted in Acquired bleeding, Anticoagulation, Platelet disorders | Tagged , ,

Case 81 – the beginning

Posted on 23/07/2017 by

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

Posted on 16/07/2016 by

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

Posted on 14/07/2016 by

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

Posted on 12/07/2016 by

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

Posted on 10/07/2016 by

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

Posted on 10/10/2015 by

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

Posted on 08/10/2015 by

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

Posted on 07/10/2015 by

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

Posted on 06/10/2015 by

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

Posted on 05/10/2015 by

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

Posted on 04/10/2015 by

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

Posted on 20/02/2015 by

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

Posted on 18/02/2015 by

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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