Hematology Case Studies

 

hematology case studies

Case studies are board-style questions with explanations and links to related articles featured in TraineE-News, an e-newsletter that is sent to hematology trainees on a quarterly basis. Year-Old Woman With Headache and Blurred Vision. Teaching Cases. ASH Teaching Cases emphasize standard approaches to classic hematologic problems and are designed to simulate the steps involved in diagnosing a patient, from taking the history and performing a physical exam, to ordering and interpreting lab tests, to making a final diagnosis and following the clinical course of the disease. History. 23 year old male. Over the past week noted increasing fatigue, sore throat, earaches, headaches, and episodic fever and chills. Unable to run his customary 25 miles per week.


Year-Old Woman With Headache and Blurred Vision


A year-old woman with a history of sickle cell disease SCD presents to the clinic for follow-up hematology case studies a hospitalization for a vaso-occlusive pain crisis complicated by influenza A. She has a history of an acute ischemic stroke at age 5 years and has received monthly, simple red cell transfusions since the stroke.

Her last transfusion was approximately four months prior. The incidence of primary stroke in children with SCD is 0. Cooperative Study of Sickle Cell Disease. Once stroke has occurred, the incidence of recurrent secondary stroke ranges from 47 to 93 percent in patients not started on regular transfusions. These high-risk children had an increased blood flow in the internal carotid or middle cerebral artery by TCD, hematology case studies.

This study showed a 92 percent reduction in incidence of first stroke in transfused high-risk patients. A follow-up study, hematology case studies, STOP2, randomly assigned 72 children whose TCD had normalized after 30 months of transfusion therapy to either ongoing or discontinued transfusions. The study was closed early due to a significant increase in abnormal TCD velocity and stroke risk for those who halted transfusion therapy. Data showed that hydroxyurea at maximal tolerated dose was noninferior to chronic transfusions for maintaining TCD velocities as primary stroke prophylaxis choice C.

The primary endpoint was a composite of noninferiority for stroke prevention and superiority for reduction of liver iron content. The trial was terminated at the first scheduled interim analysis for futility for the composite endpoint, which required superiority of phlebotomy over iron chelation for reducing excess hematology case studies stores. The incidence of stroke on the hydroxyurea plus phlebotomy arm was higher 7 of 67 patients; These results, though not powered for inferiority, showed a trend towars increased stroke risk with transition to hydroxyurea.

In patients with prior stroke, cessation of transfusion therapy is currently not recommended. Whether chronic transfusion therapy can be stopped after a longer period of transfusions in a patient with a prior stroke remains unclear even though risk of recurrent stroke remains high in adolescence and young adulthood. In patients older than 16 years, TCD velocity criteria to determine stroke risk is not reliable choice D.

The trial ended eight months early after the occurrence of 15 cases of pneumococcal sepsis, 13 in the placebo group and two in the penicillin group, showing an 84 hematology case studies reduction in pneumococcal sepsis with penicillin prophylaxis.

The follow-up study, PROPS II, did not show an increased risk in pneumococcal infections with discontinuation of prophylactic penicillin after age 5 years.

Therefore, prophylactic penicillin is not recommended in adults with SCA choice B. The trajectory of ferritin in this patient has not been established and an increase in oral iron chelation is not indicated at this time. Phone Fax Research In This Section. Blood Advances. Annual Meeting Abstracts. In This Section:. In This Section. Support Medical Research, hematology case studies. Highlights of ASH. Meeting on Hematologic Malignancies. The Hematologist. ASH Clinical News.

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Hematography Case Study 1

 

hematology case studies

 

m w M PRESCRIPwION O!! R v v v! "# $ % & Platelet count Normal range PBS Normocytic, normochromic, Few spherocytes, increase in neutrophilic bands, few early WBCs, 3 nucleated RBCs Urinalysis 3+ blood Urine and sputum cultures negative chemistry profile elevated levels of total bilirubin, alkaline phosphatase, lactate dehydrogenase, and aspartate aminotransferase direct antiglobulin test 5/5(1). These 36 HEMATOGRAPHY Case Studies were added to the Web site between October, and September, The cases are factual and reflect medical practice of that time. They have not been embellished or updated in any way. Each case illustrates a different hematologic disorder, and includes. TEACHING CASES. Case 1: A 73 year old man with fatigue, weight loss, anemia and mild thrombocytopenia for five months. Case 2: A 56 year old man with weight loss and microcytic anemia. Case 3: A 38 year old renal transplant recipient with worsening anemia. Case 4: A .