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Tag Archives: haemophilia A
Case 76 – summary
This case focussed on a newly diagnosed patient with haemophilia A. The patient was three days old and presented non-specifically unwell and feeding poorly. The differential here is wide from sepsis to hypoglycaemia to congenital heart defects and metabolic disorders. … Continue reading
Posted in Inherited bleeding, Paediatric haematology
Tagged 50:50 Mix, bleeding, FFP, genetics, haemophilia, haemophilia A, inhibitor, neonatal, paediatrics, Prolonged APTT
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Case 76 – update 4
Our patient is doing well with recombinant VIII replacement. Monitoring scans reveal shrinking of the haemorrhage. On further questioning his mother suffered bleeding post dental extraction requiring re-packing and menorrhagia along with easy bruising. Haemophilia A is an X linked … Continue reading
Posted in Inherited bleeding, Paediatric haematology
Tagged 50:50 Mix, bleeding, FFP, genetics, haemophilia, haemophilia A, inhibitor, neonatal, paediatrics, Prolonged APTT
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Case 76 – update 3
Our patient is started on recombinant factor VIII replacement and achieves a trough level of 100%. Neurosurgery is not required. Genetic samples are sent to examine the F8 gene to see where the mutation is as this can help investigate … Continue reading
Posted in Inherited bleeding, Paediatric haematology
Tagged 50:50 Mix, bleeding, FFP, genetics, haemophilia, haemophilia A, inhibitor, neonatal, paediatrics, Prolonged APTT
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Case 76 – update 2
Factor assays are back. IX, XI and XII are within normal limits for neonates but VIII is <1%. This confirms the diagnosis of severe haemophilia A. The child is transferred to the regional haemophilia centre for intensive VIII replacement … Continue reading
Posted in Inherited bleeding, Paediatric haematology
Tagged 50:50 Mix, bleeding, FFP, genetics, haemophilia, haemophilia A, neonatal, paediatrics, Prolonged APTT
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Case 76 – update 1
Our three day old child is admitted unwell and has deranged clotting with a markedly prolonged APTT. The team wanted an ultrasound scan which confirms a small intraparenchymal bleed. Repeat coagulation testing shows: PT 18s (12-14 adult) APTT 92s (30-38 … Continue reading
Posted in Inherited bleeding, Paediatric haematology
Tagged 50:50 Mix, bleeding, FFP, haemophilia, haemophilia A, neonatal, paediatrics, Prolonged APTT
Leave a comment
Case 74 – summary
Thankyou for your input this week!This week we had a look at a few abnormalities that can be seen on coagulation screens in a pre procedure setting. The first thing to say is there is no replacement for a good … Continue reading
Case 74 – part 2
So our second case starts with a phone call from the anaesthetic consultant in the pre op clinic. He has a 20 year old man that needs a wide excision of a suspicious mole on his back. He has been … Continue reading
Case 64 – part 1 – summary
We started with a 72 year old gentleman who was having an elective pacemaker insertion. He had an isolated prolonged APTT and we have previously used the following flow chart to make a diagnosis: It should be remembered that … Continue reading
Case 64 – part 1c
Our patient has a long APTT and has a haematoma and extensive bruising following pacemaker insertion. He is not on any anticoagulation, but does not have any previous clotting screens to compare to. Given the bleeding history, FFP is administered … Continue reading
Case 64 – part 1b
The patient with abnormal clotting resulst goes ahead with his planned pacemaker insertion. There is no major bleeding during the procedure but afterwards there is a large haematoma around the pocket with extensive bruising. Repeat clotting screen shows: PT … Continue reading
Case 64 – part 1a
This week we’re going to present a series of short cases around clotting results. Hopefully we’ll demonstrate when coagulation screens should be used and also how to interpret basic abnormalities. It most be noted that different labs will use different … Continue reading
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