Sandbox:Sogand
Anemia | ||||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2]
Abnormal hematosis
year | author | past history | imaging finding | ||
---|---|---|---|---|---|
Past medical history was unremarkable | coronory angiography | intracoronary imaging | CTCA | ||
Staging for mycosis fungoides and Sezary syndrome | ||
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Skin (T) | ||
T1 | Limited patches, papules, and/or plaques covering <10% of the skin surface. May further stratify into T1a (patch only) versus T1b (plaque patch) | |
T2 | Patches, papules, or plaques covering 10% of the skin surface. May further stratify into T2a (patch only) versus T2b (plaque patch). | |
T3 | One or more tumours (1-cm diameter) | |
T4 | Confluence of erythema covering 80% body surface area | |
Node (N) | ||
N0 | No clinically abnormal peripheral lymph nodes; biopsy not required | |
N1 | Clinically abnormal lymph nodes; histopathology Dutch grade 1 or NCI LN0-2 | |
N1a | Clone negative | |
N1b | Clone posetive | |
N2 | Clinically abnormal peripheral lymph nodes; histopathology Dutch grade 2 or NCI LN3 | |
N2a | Clone negatove | |
N2b | Clone posetive | |
N3 | Clinically abnormal peripheral lymph nodes; histopathology Dutch grades 3e4 or NCI LN4; clone positive or negative | |
NX | Clinically abnormal peripheral lymph nodes; no histologic confirmation | |
Visceral (M) | ||
M0 | No visceral organ involvement | |
M1 | Visceral involvement (must have pathology confirmation and organ involved should be specified) | |
Blood (B) | ||
B0 | 0 Absence of significant blood involvement: 5% of peripheral blood lymphocytes are atypical (Sezary) cells B0a Clone negative B0b Clone positive | |
B1 | Low blood tumour burden: >5% of peripheral blood lymphocytes are atypical (Sezary) cells but does not meet the criteria of B2 B1a Clone negative B1b Clone positive | |
B2 | High blood tumour burden: 1000/mL Sezary cells with positive clone |
Mycosis fungoides | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Stage IA-IIA | Stage IIA | Stage III | Stage IV | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
• Expectane policy • Topical steroides [IV-A] • nb-UVB[III,A] • PUVA [III-A] • Topical mechlorethamine [II,B] • Local RT [IV,A] | • Skin direct therapy(SDT) + local radiotherapy • ST[III+A] • (SDT+) retiods[III,B] • (SDT+) IFN a {III,B] • TSEBT [III,A] | • (SDT+) retinoides • (SDT+) IFNa • ECPI INFa +/- rtinoides • Low dose MTX • [IV-B] | • Gemcitabine • Liposomal doxorubicin • Brentuximab vedotin[II,B] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
• (SDT+) retinoides [III,B] • (SDT+) IFNa [III,B] • Retinoides +IFN a [II,B] • TSEBT [IV,A] | • Gemcitabin [IV,B] • Liposomal doxorubicin [IV,B] • Brentuximabvedotin [II,B] • Combinatio Cht [Iv,B] • AlloSCT[V,C] | TSEBT[LV,B] | • Combination Cht [IV,B] • AlloSCT [V,C] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]
On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from disseminated intravascular coagulation (DIC) , thrombotic thrombocytopenic purpura (TTP),systemic vasculitis , [disease 4], [disease 5], and [disease 6].
Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | |||||||||||||||||||||||
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Symptoms | Physical examination | ||||||||||||||||||||||||||
Lab Findings | Occur | Histopathology | |||||||||||||||||||||||||
Diarrhea | Abdominal pain | decrease urin | Physical exam 1 | Physical exam 2 | fd | CBC | PC | PT | PTT | FDP | D-dimer | LDH | haptoglobin | Coombs test | PBS | BUN | Cr | S/C | Pediatric | Adult | Imaging 3 | ||||||
Disseminated intravascular coagulation (DIC) | NL/_ | ↑ | ↑ | ↑ | ↑ | ||||||||||||||||||||||
Hemolytic uremic syndrome | Hemolitic anemia | NL | NL | NL | ↑ | ↑ | ↑ | ↑ | ↑ | +++ | + | ||||||||||||||||
Thrombotic thrombocytopenic purpura (TTP) | + | +++ | |||||||||||||||||||||||||
Systemic vasculitis | |||||||||||||||||||||||||||
Diseases | Symptom 1 | Symptom 2 | Symptom 3 | Physical exam 1 | D | Physical exam 3 | Lab 1 | Lab 2 | Lab 3 | Imaging 1 | Imaging 2 | Imaging 3 | Histopathology | Gold standard | Additional findings | ||||||||||||
Differential Diagnosis 4 | |||||||||||||||||||||||||||
Differential Diagnosis 5 | |||||||||||||||||||||||||||
Differential Diagnosis 6 |
References
Differentiating between Hemoglobinopathies
Gene type | Red blood cell (RBC) count g/dl | Hemoglobin pattern | Differentiating Symptoms | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Hemoglobin g/dl | MCH /pg | Hemoglobinpattern | ||||||||
Alpha Thalassemia | -+/++ | Normal | Normal | Normal | Normal | None | ||||
-+/-+
--/++ |
Normal or low | <26 | Normal | Normal | Mild anemia | |||||
--/-+ | 8 to 10 | <22 | HbH &asymp
10 to 20% |
HbH 10 to 20% | Chronic hemolytic anemia | |||||
Hb Bart’s hydrops fetalis
--/-- |
<6 | <20 |
|
Hb Bart’s 80 to 90%,
Hb Portland 10 to 20%, HbH <1% |
Life-threatening fetal anemia | |||||
β-thalassemia | Heterozygous | &β/++ | 9 to 15 | HbA2 >3.2% | ||||||
&β/+- | HbF 0.5 to 6% | |||||||||
&β/-- | 19 to 25 | |||||||||
Compound heterozygous | β + /β 0 | |||||||||
Homozygous | β+/β+ | <7 | ||||||||
β 0 /β 0 | ||||||||||
Sickle cell Disease | 6 to 9 | |||||||||
HBC |
Pathophysiology
- The pathophysiolgy of xxx disease in unknown.
- But it may follow xxx pathway
- It is believed that xxx might work on yyy to produce zz.
Pathology
- Idiopathic
- Itarogenic
- cardiac
References
History & clinical symptoms | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Blood test | hemolysate | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Diagnosis of abnormal hemoglobins | Diagnisis of β-thalassemia | Dignisis of α-thalassemia | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Alkaline electrophoresis • acid electrophoresis •HPLC | Electrophoresis HPLC • HbA2,Hbf | Electrophoresis HPLC • DNA testing | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Evidence of abnormality,comparison of mobility with that of known abnormalities, if HBS suspected: solubility test | Separation/quantification | Evalution of all data and findings | Evalution of all data and findings | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Diagnisis of β-thalassemia | Dignisis of α-thalassemia | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
DNA sequencing if needed | DNA sequencing if needed(thalassemia major, thalassemia intermedia | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Evaluation of all data and findings(including blood count ethnic and origin | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Diagnosis of hemoglobinopathy | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||