Tag Archives: paediatrics

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

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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

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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

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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

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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

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

Posted in Anaemia, Paediatric haematology | Tagged , , ,

Case 63 – summary

Thanks to everyone who has taken part in this week’s case. It focused on childhood anaemia and it’s investigations. See a link to our Storify of this week’s case https://storify.com/TeamHaem/case-63-a-pale-child   Childhood anaemia There are a number of causes of anaemia … Continue reading

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Case 63 – update 4

Our four year old appears to have acute parvovirus infection. It commonly causes reduced rd cell production but this is generally only significant in patients with increased red cell destruction, who rely on a very active marrow e.g. inherited and … Continue reading

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Case 63 – update 3

Our four year old has spherocytes on the blood film. These are seen in various types of haemolytic anaemias – mainly autoimmune haemolysis and hereditary spherocytosis. There is a lack of polychromasia reflecting the lack of marrow turnover and linking … Continue reading

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Case 63 – update 2

Our four year old has been having fever and is pale. A blood count showed: Hb 45g/l (115-145g/l) MCV 85fL WCC 12×10*9/l (5-15×10*9/l) with normal white cell differential Platelets 352×10*9/l (150-450×10*9/L) Reticulocytes 5×10*9/l (50-100×10*9/l)   A blood film is requested and … Continue reading

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Case 63 – update 1

We have a pale four year old boy who appears to be generally unwell with occasional fever and sore throat. On examination his observations show a tachycardia of 140bpm and respiratory rate of 35rpm. There is no menginism. There are … Continue reading

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Case 63 – the beginning

You are a general practitioner and are reviewing a four year old boy. His mother is worried that he is looking rather pale and has been unusually tired and off his food. He has a sore throat and occasional fever over … Continue reading

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Case 30 – summary

We have established that our newborn baby with an intracranial haemorrhage has a low platelet count and have debated the likely cause for this. The list of differentials include: Maternal ITP  (Immune thrombocytopenic purpura: autoimmune destruction of platelets) which can … Continue reading

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Case 30 – update 1

So, we have a neonate with an intracranial haemorrhage, diagnosed after birth due to decreased responsiveness. You had a number of questions for mum and suggestions for tests, including: HISTORY: Medications taken during pregnancy:     only folic acid. Unexplained bleeding in … Continue reading

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Case 30 – the beginning

And we don’t mean we’ve only just entered our 4th decade (we wish!) but that we are now on to our 3oth case. So far we’ve covered a massive range of topics, from common conditions to the truly obscure, neonatal medicine … Continue reading

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Our Second Christmas Cracker: Summary

The first clinical information we gave you is this blood film: You all felt that this film was very worrying and pointed out the numerous blasts, megakarytocyte fragments and abnormal nucleated erythrocytes. When we revealed that this was a newborn … Continue reading

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Case 15 – update 2

The FBC is ordered that day.  One of the laboratory staff calls the GP with the results. Hb 91 g./l WCC 5.6 x10*9 neut 1.3×10*9 plt 7 x 10*9 what is your differential now? Concerns for this patient? Further investigations

Posted in Acute leukaemia, Paediatric haematology | Tagged , , | 2 Comments