Tag Archives: thrombocytopenia

Case 100 (part D) – summary

The patient had mild thrombocytopenia and has suffered epistaxis. Epistaxis is relatively common and therefore structural causes should also be looked into. This is especially so if the nose bleeds are unilateral. There is a wide differential of why someone … Continue reading

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Case 100 (part D) – update

You repeat the FBC and it shows similar results Hb 141g/l (130-180) MCV 89fl (82-98) WCC 7.5×109/l (4-11) Neutrophils 4.7×109/l (1.7-7.5) Lymphocytes 2.1×109/l  (1.5-4.5) Platelets 70×109/l (150-450) Coagulation screen – normal U&E/LFT – normal Blood film: Questions What is the … Continue reading

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Case 100 (part D) – the beginning

You are a GP evaluating a 12 year old boy with persistent nose bleeds. He otherwise feels well with no past medical history. He is on no medications. FBC shows: Hb 140g/l (130-180) MCV 90fl (82-98) WCC 8.5×109/l (4-11) Neutrophils … Continue reading

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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

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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

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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

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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

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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

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Case 84 – summary

Thank you for all your help with this weeks case! This week we looked at a case of a patient with type 1 Gaucher’s disease . She was found to be mildly anaemia with a mild thrombocytopenia. A CT scan … Continue reading

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Case 84 – update 2

So we have the results of our patient’s bone marrow and it looks to be consistent with Gaucher’s disease! Our patient has a raised serum ACE and ferritin which is typical of Gaucher’s disease. Our bone marrow shows the typical … Continue reading

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Case 84 – update 1

So we have an update: We have found our patient is thrombocytopenic, and has a mild normocytic anaemia. Our patient has been slightly tired for a year or so, but still manages to do her demanding job as a PE … Continue reading

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Case 84 – the beginning

Welcome to our new case! We start in the GP surgery with a 21 year old woman. She has been feeling tired for a while so has come to get checked. Your colleague did some bloods on the previous visit … Continue reading

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Case 81 – summary

Thank you for all the contributions to the case this week. The case We looked at a case of a 58 year gentleman who had an incidental finding of thrombocytopenia, whilst on apixaban therapy. Immediate intervention was required to stop … Continue reading

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Case 81 – update 2

Thankfully the bleeding resolves and no surgical intervention is required The platelet count responds to IVIG, and dexamethasone 40mg given for four days. Any further investigations required?   2 week s following commencement of steroids the platelet count has fallen … Continue reading

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Case 81 – update 1

Our followers have come up with a very comprehensive list of investigations! Our advice/investigation included stopping apixaban Checking Fbc ? Any other abnormalities/previous FBC/ clot in sample  coagulation.  Prolonged PT, normal aptt and fibrinogen renal and liver function HIV, hepatitis … Continue reading

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Case 81 – the beginning

A 58 year old gentlemen has routine bloods taken at the GP surgery.  He is noted to have a platelet count of 38. His doctor rings you as the haematology registrar for advise as he is on apixaban for treatment … 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 61 – update 1

What have we found out so far? We have a 15 year old girl who has presented with a few week history of easy bruising.  Blood tests have shows a microcytic anaemia with ferritin of 5 and a thrombocytopenia with … 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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