Tag Archives: iron deficiency

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 79 – summary

Thankyou for your help this week! This week we had a look at HHT. Our patient was diagnosed with HHT aged 30 after a history of epistaxis was noted. On further questioning she was also found to have cutaneous telangectasia. … Continue reading

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Case 79 – update 2

We have found out our patient has HHT. We know she has epistaxis, and cutaneous telangectasia. She has also required courses of iron for iron deficiency, and is currently anaemic. Patients with HHT may develop AVM and some teamhaem follower … Continue reading

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Case 79 – update 1

So we have an update Our patient has presented with a long history of epistaxis. There is no history of easy bruising.  No bleeding after tooth extraction Her mother died of a brain haemorrhage and also had significant history of … Continue reading

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Case 79 – the beginning

Welcome to our new case! This week we start with a 30 year old lady who has come to her GP for a routine discussion for the contraceptive pill. In her medical history you note that she has had significant … Continue reading

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Case 66 – summary

Thanks for all who have been involved in this week’s case.  We reviewed the causes of thrombocytosis in general and also applicable to pregnancy. Causes of thrombocytosis are usually reactive or secondary to another cause: Blood loss Infection/inflammation Malignancy Thrombopoietin … Continue reading

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Case 66 – update 3

Our patient is diagnosed with essential thrombocythaemia/thrombocytosis (JAK2 V617F positive) and is started on aspirin 75mg od.   At 28 weeks she has a painful swollen left leg. It is hot and tender. An ultrasound confirms a deep vein thrombosis. … Continue reading

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Case 66 – update 2

All reactive causes of thrombocytosis have been ruled out and our pregnant patient has a persistently elevated platelet count of 500×10*9/L. There is no history of VTE or miscarriage. There are no systemic symptoms such as weight loss, rash or … Continue reading

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Case 66 – update 1

Our pregnant patient with thrombocytosis has ferritin checked which is low at 17ug/l. Her CRP was also checked and it was <5ug/l. She is prescribed oral iron replacement – ferrous sulphate 300mg TDS and a FBC post iron replacement shows: … Continue reading

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Case 66 – the beginning

You are a GP and are reviewing blood tests that were taken during a booking appointment for a 29 year old who is 10 weeks into her first pregnancy. They show: Hb 100g/L (105-165) MCV 76fL (82-98fL) WCC 10×10*9/L (4-11) Neutrophils … Continue reading

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Case 61 – summary

Thank you for all your help this week! This week we looked at a case of childhood ITP.  Our patient presented with easy bruising over a 3 week period, and had had a minor urti the previous month. The patient … Continue reading

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Case 61 – update 2

So time for another update! Our patient has been started on oral iron for a iron deficiency anaemia. Given that she only has some bruising and a slight petechial rash the decision has been made to monitor her, but not … Continue reading

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Case 45 – summary

This case dealt with two relatively common problems. We had a pregnant patient who was both iron deficient and thrombocytopenic. 1) Iron deficiency in pregnancy Anaemia in pregnancy is fairly common. There can be a 45% increase in plasma volume which will … Continue reading

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Case 45 – update 4

The iron deficiency anaemia has resolved. A ferritin was checked (although not technically necessary) and it was reassuringly well within the normal range indicating adequate iron stores. Now the issue is she is thrombocytopenic in week 36: Hb 118g/L MCV … Continue reading

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Case 45 – update 3

The blood film in the earlier post has been reported as : “Microcytic anaemia with no specific features of iron deficiency or haemoglobinopathy; suggest check iron status” The HPLC shows no variant haemoglobin and the HbA2 is within normal limits … Continue reading

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