9 December 2017 (Saturday) - Cold Storage? - NO!

This article looked interesting.

http://transfusionnews.com/2017/12/06/cold-storage-for-platelets

I saw the “cold storage for platelets” bit and naively assumed there was a change of policy on the way… then I read it…

“Platelets are normally transfused either …. Blah blah blah…. has since transfused a total of 21 of 119 units stored at 1-6°C. However, >80% were discarded due to the short storage time and formation of clots in the current plasma-rich storage solution…..”

There’s nothing new to be had from this, but this illustrates the point not to be taken in by attention-grabbing headlines.

8 December 2017 (Friday) - P. knowlesi

This picture appeared in the Facebook Hematology Interest Group today

“28 year old male, had been in Sabah (in Borneo) for 4 weeks. Presented to their GP with headaches, fever and dark urine. No antimalarials taken.

Hb = 139 g/L, WCC = 4.7 x 10^9/L, platelet clumping was evident on the blood film so no platelet count reported.

ICT negative, Illumigene Malaria DNA test positive. Parasite count reported as <0.01%.

As you can see, morphology resembles P. malariae. Confirmation of P. knowlesi was given by PCR performed by the reference laboratory.

The parasite count was unusually low. Previous P. knowlesi infections have presented with a high parasite count.”

I’ve never seen P. knowlesi. I’ve always been under the impression it looks like P. malariae (not that I’ve seen much of that) but I’ve learned something here – “Previous P. knowlesi infections have presented with a high parasite count”.

8 December 2017 (Friday) - Leaukaemic Transformation

This picture appeared in the Facebook Hematology Interest Group today

“84 yr old female in ED today for fatigue x6 days

WBC 292

HGB 4.1 mg/dL

PLT 21

History of leukocytosis/ myelofibrosis from 2010. Genetic testing positive for JAK2 mutation, chromosome 6 deletion.

Appears to have transformed to full acute leukemia now.

Diff 92% blasts”