Category Archives: Transfusion

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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Case 34 – update 2

We have a patient with sickle cell anaemia post op who is now more anaemic. She also has a sickle cell crisis with abdominal pain. She has a rather elevated CRP which may be post op or due to the … Continue reading

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Case 34 – update 1

Thanks for all of the great contributions on Twitter via #teamhaem We have initiated basic treatment for patients with a potential sickle cell crisis: Oxygen if hypoxic Hydration Analgesia Keep warm Low threshold for antibiotics Septic screen Our patients investigations show: … 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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Morphology – case 5 (summary)

Thanks for all of your responses. The full blood count of our patient showed Hb 82g/L, PLT 34×10*9/L, WCC 6.2×10*9/L, neuts 0.34×10*9/L. The film showed abnormal leukaemic blast cells which are occasionally bilobed and heavily granulated with stacks of Auer … 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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