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General Hematology Slide Review

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General Hematology Slide Review 15 month old with pallor and hemoglobin 2.5g/dl, MCV 62fl and retic 4% Drinks 48 oz of whole milk/day What is this child s problem? – PowerPoint PPT presentation

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Title: General Hematology Slide Review


1
General Hematology Slide Review
2
  • 15 month old with pallor and hemoglobin 2.5g/dl,
    MCV 62fl and retic 4
  • Drinks 48 oz of whole milk/day
  • What is this childs problem?

3
Iron Deficiency Anemia
4
  • Family lives on a farm and brings in their 2yo
    for you to examine
  • Child is pale and an HPD reveals a hemoglobin
    4g/dl, MCV 102fl
  • You diagnose a macrocytic anemia secondary to
    what?

5
Folate deficiency
  • Unpasteurized Goats Milk

6
  • 7 yo boy with
  • fever x 1 week
  • Hemoglobin 9g/dl
  • WBC 1,200
  • Plt 32K
  • Ferritin 6000

7
Whats his diagnosis?
  • Hemophagocytic syndrome

8
Hemophagocytic Syndrome
  • Non-malignant disorder of antigen-presenting
    macrophages
  • Caused by
  • Uncontrolled hemophagocytosis
  • Defective NK cell function
  • Cytokine upregulation
  • Familial and sporadic forms
  • Appears in association with
  • Bacterial, parasitic or viral (EBV) infections
  • Malignancy
  • Drugs
  • Connective tissue disorders (SLE, Kawasakis)
  • Diagnosis
  • Fever, splenomegaly
  • Cytopenias (gt2 cell lines)
  • Elevated ferritin, triglyceride
  • Hemophagocytosis in marrow, spleen, lymph nodes
  • Prompt diagnosis/treatment essential

9
What is this?
  • 14 month old African-American child presents with
    mild anemia HPD obtained and when reviewed
    showed these cells.
  • What are they?

10
  • Elliptocytes
  • Hereditary Elliptocytosis

11
(No Transcript)
12
  • 5 yo African-American boy recently presented with
    fever. Prescribed Bactrim for presumed otitis
    media. Brought back in by mom due to increased
    fatigue and this peripheral smear

13
What is the cause of this peripheral smear?
  • Glucose 6-Phosphate dehydrogenase (G6PD)
    deficiency

14
G6PD Deficiency
  • Jaundice in first 24 hours of life (pathologic
    jaundice)
  • G6PD gene located on X chromosome females can
    be affected
  • Common in certain ethnic groups

15
  • Newborn in your practice healthy, no prenatal
    complications
  • His newborn screen results comment on a fast
    band seen on hemoglobin separation

16
Whats his diagnosis?
  • Hemoglobin H disease

17
Hemoglobin H Disease
  • Caused by 3-gene deletion a thal
  • Excess b chains
  • Tetramers precipitate forming red cell inclusions
  • High O2 affinity leading to reduced O2 carrying
    capacity

18
  • 2 yo AAM presents with pain in lower extremities
    x 2 days
  • Peripheral smear and hemoglobin separation reveal
    this
  • Whats the diagnosis?

19
Homozygous sickle cell anemia
20
  • Same patient presents with h/o fever and marked
    pallor
  • Hemoglobin 2.5g/dl
  • Retic 0.1
  • Whats your diagnosis?

21
Aplastic Crisis
  • Parvovirus B19 infection

22
What does this child have?
23
Chédiak-Higashi
  • Autosomal recessive
  • Absence of pigment in eyes, skin and hair
  • Giant granules in leukocytes
  • Increased susceptibility to infections
  • Defective movement
  • Decreased granulation
  • Decreased microbicidal activity

24
  • Frantic doctor refers a child to your practice
    with a platelet count of 20K.
  • Child has no bleeding problems and is completely
    healthy.
  • Whats your diagnosis?

25
Pseudothrombocytopenia
  • EDTA

26
  • Another child presents with epistaxis, wet
    purpura in mouth and bruises/petechiae over trunk
    and extremities
  • Platelet count 2K with remainder of counts normal

27
Whats the diagnosis?
  • Immune Thrombocytopenic Purpura
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