Category Archives: Hematology

Macrocytic Anemia: The Workup

The workup for macrocytic anemia should include some or all the following: Peripheral blood smear Hypersegmented neutrophils and macroovalocytes → B12 and folate deficiency. Advanced B12 deficiency → pancytopenia. Target cells → chronic liver disease (anemia and thrombocytopenia are also seen). Pseudo-Pelger-Huët cells → myelodysplastic syndrome. For vitamin B12 deficiency Vitamin B12 levels Methylmalonic acid → high in vitamin… Read More »

D-dimer: Key Points

It can be challenging to make a diagnosis of acute pulmonary embolism (PE). Research has consistently shown that the clinical manifestations of PE are common in patients without PE. Additional diagnostic testing is warranted if PE is a consideration. In recent years, the D–dimer test has played an important role in the evaluation of suspected PE. Although the… Read More »

Disseminated Intravascular Coagulation (DIC)

Introduction Disseminated Intravascular Coagulation (DIC) is a very serious coagulation cascade disorder that is sometimes seen in patients with severe physiologic stressors such as sepsis, obstetric complications (e.g., placental abruption, retained products of conception, or amniotic fluid embolization) or major tissue injury from trauma, burns, shock, snake bites, or malignancy (e.g., acute promyelocytic leukemia). Patients with DIC have abnormal intravascular microthrombus formation… Read More »

Hematologic Emergencies

White cell disorders Tumor lysis syndrome →  allopurinol, hemodialysis Leukostasis (leukemia patient with very high white cell count and neurological changes) → leukophoresis Acute hyperviscosity syndrome (in Waldenström macroglobulinemia) → plasmapheresis Red blood cell disorders Methemoglobinemia → oxygen, methylene blue Sickle cell emergencies: Acute calculous cholecystitis → antibiotics, consider surgical intervention Acute splenic sequestration crisis (shock, LUQ pain, acute anemia, reticulocytosis) →… Read More »

Book Review: Haematology, A Core Curriculum

I think that there are two main reasons why a lot of people believe that hematology is a tough subject to master. First, it is essential a microscopic and molecular science. Unlike cardiology or neurology, which have organs-in-chief that can be visualized quite easily in 3-dimensional space, hematology is a science of cells which permeate the entire human body.  This makes things… Read More »