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Category Archives: Transfusion
Case 90 – summary
We started with a 74 year old gentleman who was admitted with weight loss, fatigue and change in bowel habit. A mass in the right iliac fossa was palpated and a colonic malignancy was suspected. He had thrombocytosis with microcytic indices … Continue reading
Case 90 – update 4
Here is the antibody panel. Can you identify the antibody?
Case 90 – update 3
Our patient is one week post two units of blood and his haemoglobin is back to baseline and has hyperbilirubinaemia. LDH is elevated and haptoglobins are absent. Blood film shows spherocytes. Here is the antibody screen Questions (For fun!) can … Continue reading
Case 90 – update 2
Our patient is treated for potential pulmonary oedema associated with blood transfusion (transfusion-associated circulatory overload). The differential was TRALI but given its rarity and the patient’s observations (hypertension and a positive fluid balance) TACO was felt to be more likely. … Continue reading
Posted in Anaemia, Transfusion
Tagged anaemia, blood transfusion, CXR, Delayed transfusion reaction, haemolysis, iron deficiency, TACO, transfusion reaction
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Case 90 – update 1
Our patient has deteriorated towards the end of a two unit transfusion. He is short of breath and more hypoxic compared to previous. Observations are below: Before unit one Towards end unit two Pulse 72bpm 98bpm Blood pressure 100/70mmHg … Continue reading
Posted in Anaemia, Transfusion
Tagged anaemia, blood transfusion, CXR, iron deficiency, TACO, transfusion reaction
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Case 90 – the beginning
A 74 year old male is admitted to hospital with weight loss, fatigue and change in bowel habit. He is pale and a mass is palpated in the right iliac fossa. A full blood count is performed: Hb 72g/l MCV … Continue reading
Posted in Anaemia, Transfusion
Tagged anaemia, blood transfusion, CXR, iron deficiency, TACO, transfusion reaction
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Case 86 – part C2
Thanks for your help with this short case. We examined this blood film of an unwell female: The most striking abnormality is red cell fragmentation. This can be seen in: AIHA/Evans’ syndrome DIC Pregnancy-associated (HELLP, pre-eclampsia, malignant hypertension, fatty liver of … Continue reading
Posted in Laboratory morphology, Platelet disorders, Thrombosis, Transfusion
Tagged FFP, haemolysis, plasma exchange, red cell fragmentation, thrombosis, TTP
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Case 86 – part 3A
A 32 year old female presents with headaches, visual disturbance and fever. Hb 92g/L MCV 99fl Platelets 38×109/l WCC and differential – mild neutrophilia Questions Name some features of the blood film? What are the differential diagnosis? What further investigations … Continue reading
Posted in Laboratory morphology, Thrombosis, Transfusion
Tagged FFP, haemolysis, plasma exchange, red cell fragmentation, thrombosis, TTP
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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
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
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
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
Case 62 – part A – update
Patient A has been with us for 48hrs. He stabilised with the prompt treatment delivered on admission, but has spiked a temp in the last 12 hours. His hickman line is still in situ. He was anaemic on admission … Continue reading
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
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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