Page 366 - Concise Pathology for Exam Preparation ( PDFDrive )

12 Haematology 351

• Infections
• Viral: HSV, rubella, smallpox, hepatitis, CMV and epidemic haemorrhagic fever
• Bacterial: Meningococcaemia and septicaemia (Gram-positive)
• Mycotic: Histoplasmosis and aspergillosis
• Protozoal: Malaria, kala-azar and trypanosomiasis
• Metazoal: Heartworm disease in dogs
• Neoplasms: Carcinoma prostate, ovary, pancreas, breast, lung, carcinoid, rhabdomyo-
sarcoma, neuroblastoma and acute promyelocytic leukaemia
• Others: PNH, incompatible transfusions, fresh water submersion and drug induced

Laboratory Diagnosis
1. Acute DIC
Clinical findings:
• Multiple bleeding sites
• Ecchymoses of skin and mucous membranes
• Visceral haemorrhage
Laboratory abnormalities: Consumption of clotting factors and platelets and intravascular
haemolysis:
• Decreased levels of Factors II, V and VIII
• Fibrinogen level below 1.0 g/L
• Increased FDP (fibrin degradation products, eg, FDP, D dimer)
• Platelet count below 100 3 10 /L
9
• Prolonged thrombin time (deficiency of fibrinogen and increased FDP levels which
inhibit thrombin activity), prolonged prothrombin time (PT) and activated partial
thromboplastin time (PTTK)
2. Chronic DIC
Clinical findings:
• Signs of deep venous or arterial thrombosis/embolism
• Superficial venous thrombosis
Laboratory abnormalities:
• Modestly increased prothrombin time in some patients
• Shortened or lengthened partial thromboplastin time
• Normal thrombin time in most patients
• High, normal or low fibrinogen level
• High, normal or low platelet count
• Increased levels of FDP (eg, on testing for FDP, D dimer)

Q. What are blood groups? Enumerate the important blood group
systems.

Ans. Blood groups are genetically determined antigens that can be detected on the RBC
surface by specific antibodies (Table 12.22).

TABLE 12.22. Important blood group systems
Name of blood group system Name of antigens
ABO H, A 1 , A 2 and B
Rh D, C, E, c and e
P P and p
MNS M, N, S and s
a
Lutheran (Lu) Lu and Lu b
a
Lewis (Le) Le and Le b
a
Duffy (Fy) Fy and Fy b
Kidd (JK) JK and JK

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