Category Archives: Platelet disorders

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

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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 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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Case 21 – summary

This case highlighted a number of important issues: 1) The differential diagnosis of thrombocytopenia associated with pregnancy Working out why a pregnant or post partum patient is thrombocytopenic can be difficult.  A number of conditions can cause thrombocytopenia to a … Continue reading

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Case 21 – update 4

The haematology team have reviewed our thrombocytopenic patient.  Heparin-induced thrombocytopenia is deemed unlikely as the HIT score is low and obstetric patients are low risk according to BCSH guidelines. One concern is the diagnosis of Post-Transfusion Purpura.  This is is … Continue reading

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Case 21 – update 3

We have now narrowed the differentials: Disseminated intravascular coagulation due to sepsis (unlikely as normal coag) Heparin-induced thrombocytopenia (possibility, but rare in obstetric patients) Thrombotic thrombocytopenic purpura (unlikely – no red cell fragments on film and more common earlier on … Continue reading

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Case 21 – update 2

The team are considering the differential diagnosis of thrombocytopenia in pregnancy/post partum.  As the patient is not bleeding heavily and platelets may worsen the condition the team have decided to hold on platelet transfusion for now. Differential diagnosis so far … Continue reading

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Case 21 – update 1

Thanks for all of your suggestions. We have a bit more information for you. Our patient is normally fit and well and delivered her first baby a week ago.  She had suffered from iron deficiency during pregnancy but didn’t tolerate … Continue reading

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Case 21 – the beginning

Welcome to #teamhaem! For those of you who are new – welcome! The case will evolve over the next week or so, depending on the information you want and suggest.  Just follow us and the hashtag #teamhaem on twitter – … Continue reading

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Morphology week – summary

Slide 1 Answer:  Bernard Soulier syndrome, bleeding disorder characterized by thrombocytopenia and large platelets.  Autosomal recessive inheritance.  Presentation consistent with low or dysfunctional platelets and include easy bruising, nosebleeds, mucosal bleeding, menorrhagia, and, occasionally, GI bleeding. Slide 2 Answer:  Hairy cell leukaemia. … Continue reading

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Morphology week – case 1

Spot diagnosis morphology for this week at teamhaem! New blood film/marrow uploaded each day. Please feel free to share any interesting blood films or marrows you have seen, and test our teamhaem followers! How would you report this blood film?  … Continue reading

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Case 13 – summary

This week’s case overs some of the issues regarding thrombocytosis.  Thrombocytosis means an elevated platelet count – usually over 450×10*9/L.  More often than not the patient is asymptomatic and it is found on a full blood count. Causes are divided … Continue reading

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Case 13 – update 4

You are concerned the patient has a primary haematological disorder due to persistence of thrombocytosis, with reactive causes being ruled out. Further appropriate investigations include: Careful study of the FBC, particularly white cell differential for basophils, monocytes and eosinophils and … Continue reading

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Case 13 – update 3

(To jump to the start of this case scroll down, click on the link to the right of here or click here: https://teamhaem.wordpress.com/2013/07/14/case-13-the-start/) Most of the team have decided that this is a reactive thrombocytosis.  The film shows left shift neutrophils … Continue reading

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Case 13 – update 2

The team have asked for some previous results.  Pre operatively the patient’s blood count was: Hb 110g/L MCV 90fL WCC 6.8×10*9/L Neutrophils 3.9×10*9/L Platelets 189×10*9/L Ferritin 182µmol/L (normal) Previous results have been similar in the not too distant past. The … Continue reading

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Case 13 – update 1

A blood film has appeared in the lab for review.  Fancy taking a peek?  Please describe what you see: Please reply on Twitter and include #TeamHaem Please reply on Twitter and always include #teamhaem to allow others to follow your … Continue reading

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