8 February 2026 (Sunday) - Wassat?

 I’ve mentioned this before. See by clicking here…

5 February 2026 (Thursday) - Thermal Amplitude and anti-A1

Here’s a rather interesting dissertation on anti-A₁.

 

I first heard about anti-A₁ in 1982 when I was working at the (now demolished) Royal East Sussex Hospital. But I never saw an example of it until I left the place and worked somewhere else.

That “somewhere else” had more cases of anti-A1 that my gran ever had cups of tea. At least one a day… until there was a huge laboratory refurbishment and re-build. The cases of anti-A1 stopped overnight, and in twenty more years there I never saw another case. Nor did I see any in the place where I worked from 2011 to 2017, nor in the place where I’ve worked ever since.

So what was going on in the late 1980s?

 

Looking back we used to do blood groups in tubes and all the testing done at room temperature was left on the drafty windowsills to incubate. Where it was cold.

And that’s where the term “thermal amplitude” comes into play. The week before the laboratory refurbishment I had a case of anti P₁ which the boss couldn’t detect because I was incubating my room temperature tubes on the drafty windowsill whereas he was doing his on the bench. We got out the thermometer…  the bench was just under 20^oC, the windowsill was 6^oC.

5 February 2026 (Thursday) - Yuk (!)

I updated my atlas with something I saw down the microscope yesterday. Click here, then click on loa loa

5 February 2026 (Thursday) - BTLP-TACT

Yet another email saying “Your manager has identified that you may need to complete further TACT participations to improve your engagement target with the system. Please visit TACT and log in at your earliest convenience”

Even though my manager denies all knowledge of this…

But it’s raining outside, it’s half an hour before “Four In A Bed” is on telly, I’m up to date on marking trainee portfolio work… so here we go.

 

I was presented with two cases:

 

12328 – a sixty-eight year-old chap in the haematology clinic needing group and save.

He grouped as A Rh(D) Positive with a negative antibody screen.

 

63393 – a forty-six year-old woman with PPH needing four units of blood within two hours.

She grouped as O Rh(D) Positive also with a negative antibody screen.

I selected four units of O Rh(D) Positive K-Negative blood

 

I got the thumbs-up

 

3 February 2026 (Tuesday) - Trivia Tuesday

 Leucocytosis is not uncommon in pregnancy… but a leucocyte alkaline phosphatase… does anyone still do those?

3 February 2026 (Tuesday) - Fritsma Factor Newsletter

The Fritsma Factor newsletter appeared in my in-box this morning. You can see it by clicking here. As always it was rather useful, and this month it had quite a lot more in it than usual…

2 February 2026 (Monday) - Learning Monday

 

It’s not Immune thrombocytopenia. The platelet count is too high and the patient would have had bruising and other symptoms which would have come to light before any surgery.

It’s not Wiskott-Aldrich syndrome as that has small platelets.

It’s not DIC as the clotting isn’t outside the normal range.

 

Large and pale platelets – grey platelet syndrome…