Tag Archives: paediatrics

Case 96 – summary

Thank you for participating in our case this week. This week we have been looking at a case of JMML (Juvenile myelomonocytic leukaemia), which is a rare clonal haematopoietic disorder of childhood, characterised by the proliferation of granulocytic and monocytic … Continue reading

Posted in Bone marrow failure, Myeloproliferative neoplasm, Paediatric haematology | Tagged , , , , , , , , , , , , ,

Case 96 – update 4

The haematology team has now taken over his care. Bone marrow aspirate has demonstrated a hypercellular marrow with left shift, and there are increased myeloid and monocyte lineages. Blast count is about 4%. There is occasional evidence of haemophagocytosis and … Continue reading

Posted in Bone marrow failure, Myeloproliferative neoplasm, Paediatric haematology | Tagged , , , , , , , , , ,

Case 96 – update 3

The blood film has been reported: – leukocytosis with neutrophilia and monocytosis, there is left shift and toxic granulation and vacuolation. Occasional primitive cells ~ 2%. No nucleated RBCs. The appearances might be reactive/infection related, and infection as well as … Continue reading

Posted in Bone marrow failure, Laboratory morphology, Myeloproliferative neoplasm, Paediatric haematology | Tagged , , , , , , , , , , , ,

Case 96 – update 2

An USS abdomen has been performed which confirms mild hepato-splenomegaly. CXR was reported as normal. Faecal elastase, TTG, TFTs, ILGF1 all normal. You phone the haematology registrar to look at the blood film in view of the abnormal FBC. Questions: … Continue reading

Posted in Bone marrow failure, Laboratory morphology, Myeloproliferative neoplasm, Paediatric haematology | Tagged , , , , , , , , ,

Case 96 – update 1

This 13 month old boy was born at 39/40 by normal delivery. His birth weight was 2.6kg. He is normally fit and well with no significant problems and no previous hospital admissions. He is up to dates with all his … Continue reading

Posted in Paediatric haematology | Tagged , , , , , ,

Case 96 – the beginning

Welcome to our new #TeamHaem case. You are an SHO in a general paediatric outpatient clinic. Your next patient is a new GP referral – a 13 month old boy who has not been putting on weight for the past … Continue reading

Posted in Paediatric haematology | Tagged ,

Case 92 – summary

Thanks for your help with the cases. This week we have looked at three different scenarios regarding bleeding or bruising presenting in the paediatric population. The cases although different have some common themes: Coagulation testing in paediatrics is challenging for … Continue reading

Posted in Acquired bleeding, Inherited bleeding, Paediatric haematology | Tagged , , , , , , , , , , , , , , , ,

Case 92 – update part A

Thanks for your help so far An 8 week old baby boy born at 40+2 by Normal vaginal delivery has a CT that confirms a subdural haemorrhage. Results: (With age adjusted reference ranges) FBC – Hb 120 (Low) MCV 120 … Continue reading

Posted in Acquired bleeding, Inherited bleeding, Paediatric haematology | Tagged , , , , , ,

Case 92 – the beginning

This week we will be looking at investigation of bleeding and bruising in the paediatric setting with three short cases. Case 1 An 8 week old baby boy born at 40+2 by Normal vaginal delivery presents with a reduced consciousness … Continue reading

Posted in Acquired bleeding, Inherited bleeding, Paediatric haematology | Tagged , , , , ,

Case 83 – summary

Many thanks to everyone who contributed to our case. This week the case centred on a pregnant female who was an obligate carrier of Haemophillia A (Her Father was affected). She had a factor VIII level of 54%. She was … Continue reading

Posted in Inherited bleeding, Paediatric haematology, Related to other specialities | Tagged , , , , , , ,

Case 83 – update 3 

Our pregnant patient had a factor VIII level of 54%. She is a carrier of intron 22 inversion as predicted from family history.  The free fetal DNA testing confirms she is carrying a male fetus. The patient has decided that … Continue reading

Posted in Inherited bleeding, Paediatric haematology, Related to other specialities | Tagged , , , , , , ,

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 , , , , , , , , ,

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 , , , , , , , , ,

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 , , , , , , , , ,

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 , , , , , , , ,

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 , , , , , , ,

Case 76 – the beginning

You are working in the emergency department of a district general hospital. Parents bring a three day old child in for assessment as he has been non-specifically unwell, looking pale and feeding poorly. He was born at term by spontaneous … Continue reading

Posted in Inherited bleeding, Paediatric haematology | Tagged , ,

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

Posted in Anaemia, Paediatric haematology | Tagged , , , , ,

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

Posted in Anaemia, Paediatric haematology | Tagged , , , , ,

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

Posted in Anaemia, Paediatric haematology | Tagged , , , , ,