Tag Archives: thrombocytopenia

Case 45 – update 4

The iron deficiency anaemia has resolved. A ferritin was checked (although not technically necessary) and it was reassuringly well within the normal range indicating adequate iron stores. Now the issue is she is thrombocytopenic in week 36: Hb 118g/L MCV … Continue reading

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Case 45 – update 3

The blood film in the earlier post has been reported as : “Microcytic anaemia with no specific features of iron deficiency or haemoglobinopathy; suggest check iron status” The HPLC shows no variant haemoglobin and the HbA2 is within normal limits … Continue reading

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Case 45 – update 2

So far we have a pregnant lady who is feeling tired and has a microcytic anaemia. It is likely she has iron deficiency. Her family origin questionnaire is done as part of antenatal screening and she states that she is … Continue reading

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Case 45 – update 1

So far we have a women who is 11 weeks pregnant and feeling tired and out of sorts. She has a microcytic anaemia and a borderline platelet count. Firstly let’s think about the anaemia. The two most common causes of … Continue reading

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Case 45 – the beginning

You are in a GP surgery as the GP registrar. A 24 year old female complains of feeling tired. She is eleven weeks pregnant and was due her ‘booking visit’ by the midwife in a one week’s time. She has … Continue reading

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Case 33 – update 1

Our 15 yr old had quite an unexpected severe bleed during her tonsillectomy.  She required tranexamic acid and blood product support intraoperatively.  Surgical haemostasis was eventually successful.  Surgeons inform us that they used the cold steel method (this meant nothing … Continue reading

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Case 32 – update 2

Our patient has been found to be HIT positive on the ELISA. He initially had a HIT screen test with a rapid gel agglutination assay for antibodies directed against the PF4/heparin complexes which is positive. This test has a good … Continue reading

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Case 32 – update 1

So what have we found out so far? We have a 40 year old man, who had one episode of ITP as a child, with dilated cardiomyopathy who is now 7 days post LVAD with plt of 30 and falling. … Continue reading

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Case 32 – the beginning

Welcome to our new case! Another haematology problem that we will need everyone’s expertise to unravel. This week we are dealing with matters of the heart! A 40 year old man with dilated cardiomyopathy, who is awaiting a heart transplant, … 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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Morphology – case 1 (summary)

Thanks for all of the responses to our blood film. We agree with the comments via #teamhaem Toxic granulation and vacuolation Crenated red cells Possible alcohol Thrombocytopenia The blood count was Hb 108g/L, MCV 98fL, WCC 18×10*9/L with  neuts 16.2×10*9/L, … Continue reading

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Case 21 – summary

This case highlighted a number of important issues: 1) The differential diagnosis of thrombocytopenia associated with pregnancy Working out why a pregnant or post partum patient is thrombocytopenic can be difficult.  A number of conditions can cause thrombocytopenia to a … Continue reading

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Case 21 – update 4

The haematology team have reviewed our thrombocytopenic patient.  Heparin-induced thrombocytopenia is deemed unlikely as the HIT score is low and obstetric patients are low risk according to BCSH guidelines. One concern is the diagnosis of Post-Transfusion Purpura.  This is is … Continue reading

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Case 21 – update 3

We have now narrowed the differentials: Disseminated intravascular coagulation due to sepsis (unlikely as normal coag) Heparin-induced thrombocytopenia (possibility, but rare in obstetric patients) Thrombotic thrombocytopenic purpura (unlikely – no red cell fragments on film and more common earlier on … Continue reading

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Case 21 – update 1

Thanks for all of your suggestions. We have a bit more information for you. Our patient is normally fit and well and delivered her first baby a week ago.  She had suffered from iron deficiency during pregnancy but didn’t tolerate … Continue reading

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Case 21 – the beginning

Welcome to #teamhaem! For those of you who are new – welcome! The case will evolve over the next week or so, depending on the information you want and suggest.  Just follow us and the hashtag #teamhaem on twitter – … 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

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Case 11 – summary

Our patient As with a number of haematological emergencies, the first sign of a major problem is through a grossly abnormal full blood count.  In this case the biomedical scientists made a blood film and confirmed the thrombocytopenia was true. … Continue reading

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