It was time for another BTLP-TACT exercise. I logged on and was presented with two cases.
68902 – a twenty-five year old woman in A&E requiring two units of blood tomorrow
04701 – a forty-year old woman in the haematology clinic also requiring two units of blood tomorrow (irradiated blood)
This grouped as O Rh(D) Negative with a positive antibody screen. The panel showed anti-C and anti-D and could not rule out anti-Cw
Two units of O Neg D Neg C Neg were selected
This grouped as A but with what looked like a weak D reaction. I called it A Rh uninterpretable. The weak D needs further investigation.
This one also had a positive antibody screen which looked to be anti-D but anti-Cw cold not be ruled out.
I gave O Neg irradiated because of the iffy Rh group…
I got the green light. I was pleased about that…
I saw this in a blood film today, and fetched everyone to come and have a look
MOUSE M D1234567 01.02.33 M TW12 Dr D Duck
R,20.3005334.Q R 24.01.20 Clinical details UGI bleed, possible pneumonia
HBM WBCM PLT HCT RBCM MCVM MCHM MCHCM RDW N
220120 F 97 10.41 125 0.289 2.88 100.3 33.7 336 18.6 8.29
230120 F 90 9.16 117 0.267 2.58 103.5 34.9 337 19.1 7.44
230120 F 90 9.40 132 0.276 2.69 102.6 33.5 326 19.2 7.92
240120 F 94 7.59 134 0.285 2.74 104.0 34.3 330 19.3 6.18
L M E B NRBC ESR GF
220120 F 1.10 0.89 0.09 0.04 0.05
230120 F 0.78 0.83 0.08 0.03 0.07
230120 F 0.62 0.72 0.09 0.05 0.08
240120 F 0.54 0.79 0.05 0.03 0.06
What’s caused the basophilic stippling in this case? I don’t really know. But from this link https://www.ncbi.nlm.nih.gov/pubmed/6202140 and this link https://en.wikipedia.org/wiki/Basophilic_stippling (good old wikipedia!!) basophilic stippling would seem to be a rather non-specific finding, and has been replaced by more specific tests in cases of suspected lead poisoning.
Labels: down my microscope
The subject of Bcr-Abl tyrosine-kinase inhibitors came up at work today. I’m not going to pretend that I had the faintest idea, so I looked it up. As always Wikipedia gave the most concise description to the layman.
I won’t pretend that I understood it all, but I understand more than I did, and (as I always say) a day when you learn nothing is a day wasted…
Labels: clinical condition