For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

A. Cold Haemagglutination disease (CHAD)

B. Haemophagocytic syndrome

C. Haemophilus influenzae

D. Hereditary spherocytosis

E. G6PD deficiency

F. Iatrogenic

G. Malaria

H. Microangiopathic haemolytic anaemia

I.  Mismatched blood transfusion

J. Paroxysmal Cold Haemoglobinuria (PCH)

K. Sickle cell disease

L. South East Asian Ovalocytosis

M. Thalassaemia

N. Warm Autoimmune Haemolytic Anaemia (WAIHA)

 

 

1. A 2-year-old child presents with shortness of breath and her parents complain she has been looking pale. The history reveals multiple family members have been diagnosed with a haemolytic anaemia. The results of the osmotic fragility test indicate her RBCs have increased sensitivity to lysis in hypotonic saline.

 

2. A 56-year-old gentleman presents with fatigue and dyspnoea on exertion. On abdominal examination, a palpable mass is felt in the LUQ. Serology indicates autoantibodies directed against red cell antigens optimally reacted at 37°C.

 

3. An 82-year-old lady with known lymphoma presents with fatigue and painful tingling in her fingers and toes, which is worse in the winter. Serology reveals IgM antibodies that bind to RBCs at low temperatures (0-4°C), at titres greater than 1/1000.

 

4. A 24-year-old Chinese lady presents very distressed with sudden onset dyspnoea. Her drug history reveals she has been taking Primaquine for a recent trip to Honduras. She describes a similar episode when exposed to naphthalene balls as a child.

 

5. A 12-year-old child presents with reddish discoloration of her urine. The history reveals she has recently suffered with flu-like symptoms. Serology identifies presence of IgG autoantibodies that bind to red cell antigens at temperatures <20°C.

 

Answers: 1 = D, 2 = N, 3 = A, 4 = E, 5 = J