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Diagnosis of Autoimmune Hemolytic Anemia (AIHA)

20 October, 2009

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.

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Diagnostic Criteria for Autoimmune Lymphoproliferative Syndrome (ALPS)

11 October, 2009

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.

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Wells Clinical Prediction Rule for Pulmonary Embolism and Deep Venous Thrombosis

8 March, 2009

The Wells Clinical Prediction Rule is a diagnostic tool used during review of systems to identify possible pulmonary embolism (PE) and deep vein thrombosis (DVT). Continue reading “Wells Clinical Prediction Rule for Pulmonary Embolism and Deep Venous Thrombosis”

Diagnostic Criteria for Essential Thrombocytopaenia (ET)

8 March, 2009

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

  1. Platelet count greater than 600 x 109/L

  2. Hematocrit less than 40 or normal red blood cell mass

  3. 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.)

  4. No Philadelphia chromosome or bcr/abl gene rearrangement

  5. 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

  6. No cytogenetic or morphologic evidence for a myelodysplastic syndrome

  7. No cause for a reactive thrombocytosis

    Continue reading “Diagnostic Criteria for Essential Thrombocytopaenia (ET)”

Diagnostic Criteria for Heparin-Induced Thrombocytopenia (HIT)

8 March, 2009

Diagnostic Criteria for Heparin-Induced Thrombocytopenia (HIT)

  • Heparin exposure >5 days
  • Relative thrombocytopenia: decrease in platelet count by 50% from baseline OR absolute thrombocytopenia: decrease in platelet count to less than 100 to 150 x 109/L
  • Absence of other causes of thrombocytopenia
  • Development of new thrombosis, or extension of pre-existing thrombosis, while receiving heparin therapy
  • Confirmation by laboratory testing
  • Return to normal platelet count when heparin is discontinued Continue reading “Diagnostic Criteria for Heparin-Induced Thrombocytopenia (HIT)”

Classification of Neutrophilia

3 March, 2009

Primary (no other evident associated disease)

    • Hereditary neutrophilia
    • Chronic idiopathic neutrophilia
    • Chronic myelogenous leukemia (CML) and other myeloproliferative diseases
    • Familial myeloproliferative disease
    • Congenital anomalies and leukemoid reaction
    • Leukocyte adhesion deficiency (LAD)
    • Familial cold urticaria and leukocytosis

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Classification of Neutropenia

3 March, 2009

Acquired neutropenia

    • Postinfectious: varicella, measles, rubella, hepatitis A and B, mononucleosis, influenza, cytomegalovirus, parvovirus, acquired immunodeficiency syndrome (AIDS), S. aureus, brucellosis, tularemia, rickettsia, Mycobacterium tuberculosis, sepsis.
    • Drug induced: Antineoplastic agents, procainamide, antithyroid drugs, sulphasalazine, phenothiazines, semisynthetic penicillins, nonsteroidal anti-inflammatory agents, aminopyrine derivatives, benzodiazepines, barbiturates, gold compounds, sulfonamides, propranolol, dipyridamole, digoxin, acetyldigoxin, sulfamethoxizole, anticonvulsants
    • Benign familial neutropenia
    • Chronic benign neutropenia of childhood
    • Chronic idiopathic neutropenia
    • Autoimmune neutropenia
    • Isoimmune neutropenia
    • Neutropenia associated with immunologic abnormalities
    • Neutropenia associated with metabolic diseases
    • Neutropenia due to increased margination
    • Nutritional deficiency

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FAB Classification of Myelodysplastic Syndromes (MDS)

2 March, 2009

Refractory anemia (RA).

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