Category Archives: Transfusion

Case 73 – summary

This week our case involved the care of a 10 year old girl with SCD who had transfered her care to the UK. She presented in outpatient clinic for the first time and we had to determine her management. During … Continue reading

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Case 73 – update 2 

Given the girls high Right MCA doppler at screening the patient started regular transfusion for prevention of CVA. This was initiated due to Adams et al 1998 NEJM paper that showed a 92% risk reduction in patients with high dopplers … Continue reading

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Case 73 – update 1

Thanks for all your suggestions so far. When the patient was seen for the first time the following was established: History: She is now age 10 and moved to the UK from west Africa a few months ago with her … Continue reading

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Case 73 – the beginning

A 10 year old girl attends paediatric outpatient clinic with a history of Sickle Cell Disease. She was born abroad and has just moved to the UK.  What history should you establish?  What should you note on examination? How would … Continue reading

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Case 62 – part A – update

Patient A has been with us for 48hrs.  He stabilised with the prompt treatment delivered on admission, but has spiked a temp in the last 12 hours.  His hickman line is still in situ.   He was anaemic on admission … 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 50 part 2 – summary

In haematology it is important integrate laboratory investigations to clinical presentations. A blood transfusion was requested in a young patient with macrocytic anaemia with no previous blood count information. The blood film was reviewed rapidly:   The diagnosis of a … Continue reading

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Case 50 part 2 – the beginning

A 21 year old female presents with chest pain. You are asked to authorise a blood transfusion as she is anaemic. Hb 69g/L (115-160) MCV 111fL (79-98) WCC 12.6×10*9/L (4-11) Neuts 10.6×10*9/L (2-7) PLT 578×10*9/L (150-400) Here is her blood … Continue reading

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Case 40 – summary

In this case we were able to interpret blood grouping cards, to allow us to determine further management for this pregnant lady. The first sample to interpret was the blood group of the pregnant lady which identified that she was … Continue reading

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Case 40 – update 3

The patient continues her pregnancy with no further complications. The baby’s blood group is shown below: what can you deduce from this blood card grouping? any further management for mum? any information regarding the fathers blood group? What other clinical … Continue reading

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Case 40 – update 2

Thankfully bleeding has eased, mum and baby are well. What dose of anti-D is required? How is this calculated? Any further tests to help with dosing? Of note she had an antibody screening with booking in bloods which was negative. … Continue reading

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Case 40 – update 1

At 26 weeks this patient presents with an antepartum haemorrhage. How would you manage this lady?

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Case 40 – the beginning

The first blood sample is taken from a 23 year old lady at her antenatal booking appointment. How do you interpret this blood grouping card? What is the patients blood group? Are there any other considerations for this patient? Answers … Continue reading

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Case 34 – summary

This was a varied case centered around an unwell patient with sickle cell anaemia post surgery. There were a number of themes to cover in this case reminding us that patients with sickle cell anaemia can be complex and require … Continue reading

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Case 34 – update 4

Our patient with sickle cell anaemia has been investigated for a delayed haemolytic transfusion reaction. However, the reticulocyte count was not elevated and the direct antiglobulin test was not positive as would be expected. Similarly there was no new antibody … Continue reading

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Case 34 – update 3

Lots of great suggestions via #teamhaem. Patients with sickling disorders need careful attention when operations are being planned. They should be carefully pre-assesed with involvement of haematologists and anaesthetists.  Important points include: Respiratory function post op – high risk of … Continue reading

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