The definition of plasma cell myeloma (PCM) has rested on identifying clinical and laboratory features that predict when a sufficient burden of plasma cells has accumulated that the patient will benefit from treatment. Continue reading →
The thalassemias are a group of inherited hematologic disorders caused by defects in the synthesis of one or more of the hemoglobin chains. Alpha thalassemia is caused by reduced or absent synthesis of alpha globin chains, and beta thalassemia is caused by reduced or absent synthesis of beta globin chains. Imbalances of globin chains cause hemolysis and impair erythropoiesis. Continue reading →
A peripheral-blood smear is a vital investigation tool in most cases to confirm a low platelet count and the presence or absence of other diagnostic features, such as red-cell fragmentation, platelet morphologic abnormalities, or evidence of dysplasia or hematinic deficiency. Continue reading →
Disseminated intravascular coagulation is a clinicopathological diagnosis of a disorder that is defined by the International Society on Thrombosis and Hemostasis (ISTH) as “an acquired syndrome characterized by the intravascular activation of coagulation with loss of localization arising from different causes”. This condition typically originates in the microvasculature and can cause damage of such severity that it leads to organ dysfunction. It can be identified on the basis of a scoring system developed by the ISTH. Continue reading →
The diagnosis of Iron Deficiency Anemia (IDA) requires that a patient be anemic and show laboratory evidence of iron deficiency. Red blood cells in IDA are usually described as being microcytic (i.e., mean corpuscular volume less than 80 um3 [80 fL]) and hypochromic, however the manifestation of iron deficiency occurs in several stages. Continue reading →
The red blood cell transfusions should not be dictated by a single hemoglobin “trigger” but instead should be based on the patient’s risks of developing complications of inadequate oxygenation. Red blood cell transfusion is rarely indicated when the hemoglobin concentration is greater than 10 g/dL and is almost always indicated when it is less than 6 g/dL.
Two criteria must be diagnose AIHA: serologic evidence of an autoantibody and clinical or laboratory evidence of hemolysis. Serologic evidence of an autoantibody is provided by positive autocontrol and direct antiglobulin test (DAT, direct Coombs´ test) results and subsequent identification of an autoantibody in the RBC eluate and possibly the serum. Serum reactivity with autologous RBCs generally indicates the presence of an autoantibody, but it does not exclude the presence of an autoantibody.
Autoimmune lymphoproliferative syndrome (ALPS) is characterized by dysregulation of the immune system due to an inability to regulate lymphocyte homeostasis through the process of lymphocyte apoptosis (a form of programmed cell death). The consequences of this include lymphoproliferative disease, manifested by lymphadenopathy, hepatomegaly, splenomegaly, and an increased risk of lymphoma, as well as autoimmune disease, typically involving blood cells.
Polycythemia Vera Study Group (PVSG) Diagnostic Criteria for Essential Thrombocytopaenia (ET)
All of the following criteria must be fulfilled to make a diagnosis of ET
Platelet count greater than 600 x 109/L
Hematocrit less than 40 or normal red blood cell mass
Stainable iron in the marrow or normal RBC mean corpuscular volume (If these measurements suggest iron deficiency, polycythemia vera cannot be excluded unless a trial of iron therapy fails to increase the red blood cell mass into the polycythemic range.)
No Philadelphia chromosome or bcr/abl gene rearrangement
Collagen fibrosis of the bone marrow absent or less than one third of the biopsy area without both marked splenomegaly and a leukoerythroblastic blood film
No cytogenetic or morphologic evidence for a myelodysplastic syndrome