Tag Archives: Macrocytosis

Case 89 – summary

  Thank you for all of the contributions with Case 89 where we encountered a fit 64 year old who presented with progressive anaemia and leucocytosis over the past 6 months. He also had associated weight loss of 0.5 stones … Continue reading

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Case 89 – update 2

Thank you for everyone’s contributions so far! Update of investigation results as requested: Bone marrow trephine: myelofibrosis. BM cytogenetics: monosomy 7 Peripheral blood: JAK2 positive. No circulating blasts identified on blood film. USS abdo: 16cm spleen (Hb 95, Plts 90, … Continue reading

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Case 89 – update 1

Thanks for everyones contributions so far. Further information now available as requested by yourselves: Patient decline over past 6 months – 0.5 stone weight loss, no night sweats / fevers. Marked lethargy and generally feeling ‘achey’. Poor appetite but no … Continue reading

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Case 89 – the beginning

A 64  year old man is referred to haematology outpatients with progressive chronic anaemia and leucocytosis. He has previously been very fit but has become very lethargic  over the past few months. Hb 95, MCV 103, Plts 90, WCC 17, … Continue reading

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Case 46 – #UnofficialCSIM2 summary

Thank you to those of you who joined in with this case; we hope it was a useful and enjoyable way to learn. We covered a few important topics during the case: the differential for a macrocytic anaemia Investigating macrocytosis … Continue reading

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Case 46 – #UnofficialCSIM2: Update 2

Mr Ordie was referred to Haematology clinic after his initial investigations were unremarkable. Bhy this point his Hb was 85g/l with an MCV of 114fl, platelets of 107. A bone marrow biopsy was performed, which showed: . IMAGE: dysplastic red … Continue reading

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Case 46 – #UnofficialCSIM2 Update 1

Thanks for all your hard work so far. We’ve established that Mr Ordie has a macrocytic anaemia with normal thyroid function tests, normal B12 and folate and no significant alcohol history. He takes methotrexate and folic acid for rheumatoid arthritis. Methotrexate … Continue reading

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Case 46 – #UnofficialCSIM2 Haematology Week

NB To our lonstanding teamhaemers: this week’s case is for medical students. Whilst we may call on some of the usual team to help us out, for now please observe without speaking! Thanks in anticipation.

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Case 17 – summary

This case involved the differential diagnosis of macrocytosis and the investigations needed in order to secure the diagnosis of haemolytic anaemia. Our gentleman presented with fatigue and dyspnoea.  On examination he was pale and further blood tests revealed a macrocytic … Continue reading

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Case 17 – update 3

Teamhaem have spoken! The film shows polychromasia and enlarged red cells – likely reticulocytes.  There are also small contracted cells  – spherocytes.  Normal red cells should be like the below: Here is our patient’s film: More results: DAT – positive … Continue reading

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Case 17 – update 1

Excellent work on this week’s case.  Almost all of the causes of macrocytosis have been identified: B12/folate deficiency Reticulocytosis Liver disease Alcohol excess Myelodysplastic syndromes Paraproteinaemia Hypothyroidism Pregnancy Cold agglutinins Drugs – DMARDS, chemotherapy, folate antagonists e.g. methotrexate, sulfasalizine, hydrocycarbamide, … Continue reading

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