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Akut hæmatologi (I)

38 år tidligere rask gymnastiklæerinde Igennem nogle uger træthed, tyngdefornemmelse abdomen Søger e.l. torsdag aften Fredag 10.00: hentes af e.l. Fredag 11.00: CS Fredag 14.00: AUH. Akut hæmatologi (I). Akut hæmatologi (I). Hæmatologiske kvantiteter Leukocytter: 322 mia/L

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Akut hæmatologi (I)

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  1. 38 år tidligere rask gymnastiklæerinde Igennem nogle uger træthed, tyngdefornemmelse abdomen Søger e.l. torsdag aften Fredag 10.00: hentes af e.l. Fredag 11.00: CS Fredag 14.00: AUH Akut hæmatologi (I)

  2. Akut hæmatologi (I) • Hæmatologiske kvantiteter • Leukocytter: 322 mia/L • Trombocytter 700 mia/L • Hgb. 7.3 mmol/L • Udstrygning: CML lignende billede Fredag 17.00 - sendes hjem på weekend (!)

  3. Akut hæmatologi (II) • 43 år tidligere rask systemrådgiver • Igennem nogle uger træthed, løs afføring, og oppustethed • Søger e.l. , der vælger at se an • Gener persisterer, e.l. foranlediger UL • Tumormasser spredt i abdomen • Henvisning til Hæmatologisk afdeing

  4. Akut hæmatologi (II) • Subileus • Urat 1.2 mmol/L, lymfocytose 17 mia./L • Burkitt lymfom/B-ALL, tumor lyse syndrom • Hydrering, allopurinol, rasburicase • Prednison • Midlertidig dialyse

  5. Akut hæmatologi (III) • 8.00 - roll call; patient on the admission ward • 8.45 - order of blood smear • 9.15 - look at blood smear • 9.30 - referred to Hem. Dept. • 9.55 - A-vitamin derivative perorally

  6. Histologi Molekylær biologi Flow cytometri Cytogenetik Leukæmidiagnostik

  7. Cytogenetik Udstrygning Biopsi Flyvefisk Molekylær biologi Diagnostisk tidsforløb Flow cytometri 0 1 2 3 4 5

  8. HLA Klasse II Akut hæmatologi (III) • 12.15 Flow cytometri • 14.15 FISH+ t(15;17)+ • 16.00 - RQ-PCR PML/RARA+

  9. Eigil Kjeldsen

  10. APL hæmorrhagi

  11. Forløb • CML - behandlet med Glivec - CR +48 • Burkitt lymfom - autotransplanteret - CR +120 • APL - ATRA + kemoterapi - CR +36

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