Tag Archives: haemolysis

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 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 67 – part 3 summary

Thankyou for all your help this week. This week we had a quick look at 3 causes for anaemia in children, although there are obviously many more! For our final case this week we had a young boy who had … Continue reading

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Case 67 – part 3

And here we have our 3rd and final case A 4 year old boy who is normally well has been bought to A&E by his dad. He has been unwell for the last few days, and dad thinks he is … Continue reading

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Case 67 – part 2 summary

We have found that our patient has PCH. PCH is a form of auto immune haemolytic anaemia which will usually present in young children. It is caused by a biphasic antibody with will usually target the P antigen on red … Continue reading

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Case 67 – part 2

Here we have our second case! A 5 year girl old presents to her A&E with her grandmother. She had been the park today and has now become generally unwell with abdominal pain, back pain, vomiting and feeling shivery. HB … Continue reading

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Case 67 – part 1 summary

So we have found our patient has g6pd deficiency precipitated by eating broad beans. With folic acid and supportive care he made a full recovery. G6pd deficiency is an X linked disorder that results in a deficiency of the enzyme … Continue reading

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Case 67 – part 1

Welcome to our cases this week. This week we will be focusing on children, with 3 short cases. Our first case begins in A&E. We have a 3 year old boy who’s  mum has bought him in because he has … Continue reading

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Case 50 part 1 -summary

Thanks for all of the contributions. The marrow showed erythrophagocytosis. This can be a sign of autoimmune haemolytic anaemia. In particular it can be seen in paroxysmal cold haemoglobinuria. We were slightly mean and didn’t show the rest of the … Continue reading

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Case 50 part 1 – update

We were reviewing the marrow smear from an elderly gentleman with weight loss and macrocytic anaemia. Further results include: Reticulocyte count 276×10*9/L Bilirubin 54ug/L LDH 1056U/L DAT IgG 4+   The above is consistent with warm autoimmune haemolytic anemia. The … Continue reading

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Case 50 part 1 – the begining

This week we will be doing some short cases based around some pictures. Each case will last around 24-36 hours, so get in quick!  As always – the information is posted here and the discussion will be on Twitter. Follow … 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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