Tag Archives: sickle cell disease

Case 73 – summary

This week our case involved the care of a 10 year old girl with SCD who had transfered her care to the UK. She presented in outpatient clinic for the first time and we had to determine her management. During … Continue reading

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Case 73 – update 2 

Given the girls high Right MCA doppler at screening the patient started regular transfusion for prevention of CVA. This was initiated due to Adams et al 1998 NEJM paper that showed a 92% risk reduction in patients with high dopplers … Continue reading

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Case 73 – update 1

Thanks for all your suggestions so far. When the patient was seen for the first time the following was established: History: She is now age 10 and moved to the UK from west Africa a few months ago with her … Continue reading

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Case 73 – the beginning

A 10 year old girl attends paediatric outpatient clinic with a history of Sickle Cell Disease. She was born abroad and has just moved to the UK.  What history should you establish?  What should you note on examination? How would … Continue reading

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Case 50 part 2 – summary

In haematology it is important integrate laboratory investigations to clinical presentations. A blood transfusion was requested in a young patient with macrocytic anaemia with no previous blood count information. The blood film was reviewed rapidly:   The diagnosis of a … Continue reading

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Case 50 part 2 – the beginning

A 21 year old female presents with chest pain. You are asked to authorise a blood transfusion as she is anaemic. Hb 69g/L (115-160) MCV 111fL (79-98) WCC 12.6×10*9/L (4-11) Neuts 10.6×10*9/L (2-7) PLT 578×10*9/L (150-400) Here is her blood … Continue reading

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Case 34 – summary

This was a varied case centered around an unwell patient with sickle cell anaemia post surgery. There were a number of themes to cover in this case reminding us that patients with sickle cell anaemia can be complex and require … Continue reading

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Case 34 – update 4

Our patient with sickle cell anaemia has been investigated for a delayed haemolytic transfusion reaction. However, the reticulocyte count was not elevated and the direct antiglobulin test was not positive as would be expected. Similarly there was no new antibody … Continue reading

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Case 34 – update 3

Lots of great suggestions via #teamhaem. Patients with sickling disorders need careful attention when operations are being planned. They should be carefully pre-assesed with involvement of haematologists and anaesthetists.  Important points include: Respiratory function post op – high risk of … Continue reading

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Case 34 – update 2

We have a patient with sickle cell anaemia post op who is now more anaemic. She also has a sickle cell crisis with abdominal pain. She has a rather elevated CRP which may be post op or due to the … Continue reading

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Case 34 – update 1

Thanks for all of the great contributions on Twitter via #teamhaem We have initiated basic treatment for patients with a potential sickle cell crisis: Oxygen if hypoxic Hydration Analgesia Keep warm Low threshold for antibiotics Septic screen Our patients investigations show: … Continue reading

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Morphology – case 2 (summary)

Thanks for all of the responses to our blood film. We agree with the comments via #teamhaem Sickle cells (more on other parts of the film!) Howell Jolly bodies Target cells Spherocytes Portuguese Man O’ War (!) (not sure Prof … Continue reading

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Morphology – case 2

A blood film has been made from the following patient with the clinical details ‘SOB’. This is the first time you have seen the patient in your hospital. Questions How do you report the film? Who else should you inform of … Continue reading

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Case 10 – summary

Sickle cell disease Obviously, in most circumstances the patient would be able to inform the medical team that they have a history of sickle cell disease – but to make this case interesting – the diagnosis was not revealed immediately!!! … Continue reading

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Case 10 – update 3

HPLC is performed for this patient. Can anyone described the results? What is HPLC? What does it detect? What are the other forms of sickle cell?

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Case 10 – update 2

So you have established that this patient has sickle cell disease.  She is currently visiting a friend in the area so she had never attended this hospital before. Her pain has been controlled temporpraily with IV morphine, however you are … Continue reading

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