Category Archives: Transfusion

Case 90 – summary

We started with a 74 year old gentleman who was admitted with weight loss, fatigue and change in bowel habit. A mass in the right iliac fossa was palpated and a colonic malignancy was suspected. He had thrombocytosis with microcytic indices … Continue reading

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Case 90 – update 4

Here is the antibody panel. Can you identify the antibody?  

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Case 90 – update 3

Our patient is one week post two units of blood and his haemoglobin is back to baseline and has hyperbilirubinaemia. LDH is elevated and haptoglobins are absent. Blood film shows spherocytes. Here is the antibody screen Questions (For fun!) can … Continue reading

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Case 90 – update 2

Our patient is treated for potential pulmonary oedema associated with blood transfusion (transfusion-associated circulatory overload). The differential was TRALI but given its rarity and the patient’s observations (hypertension and a positive fluid balance) TACO was felt to be more likely. … Continue reading

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Case 90 – update 1

Our patient has deteriorated towards the end of a two unit transfusion. He is short of breath and more hypoxic compared to previous. Observations are below:   Before unit one Towards end unit two Pulse 72bpm 98bpm Blood pressure 100/70mmHg … Continue reading

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Case 90 – the beginning

A 74 year old male is admitted to hospital with weight loss, fatigue and change in bowel habit. He is pale and a mass is palpated in the right iliac fossa. A full blood count is performed: Hb 72g/l MCV … Continue reading

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Case 86 – part C2

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

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Case 86 – part 3A

A 32 year old female presents with headaches, visual disturbance and fever. Hb 92g/L MCV 99fl Platelets 38×109/l WCC and differential – mild neutrophilia Questions Name some features of the blood film? What are the differential diagnosis? What further investigations … Continue reading

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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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