Haematology insights

In this episode, Dr. Alwyn D'Souza delves into advanced haematology topics relevant to general practitioners. They discuss the significance of ferritin levels, the implications of raised globulins, and the complexities surrounding paraproteins and myeloma. The conversation emphasises the importance of clinical judgment in interpreting lab results and understanding the broader context of patient health.

Topics

Intro.
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Notes to Haematology.
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Getting the most out of requests for advice.
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A raised ferritin result.
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Haemochromatosis.
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Difference in aetiology - mildly or highly raised ferritin.
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Disrupted iron metabolism.
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Ferritin - diagnostically interesting.
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Inflammatory disease and iron deficiency.
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Raised immunoglobulins.
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clarify paraprotein (or M-protein).
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Serum free light chains (SFLC) is an additional test.
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Monoclonal Gammopathy of Undetermined Significance (MGUS).
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Amyloidosis.
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Recap of investigative pathway.
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IgA and IgG testing.
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Raised globulins - what else are we thinking about?
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Commonly asked questions.
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Explaining to a patient.
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Take-home messages.
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Take home messages

Clinical judgment is really important.
We rarely interpret lab results in isolation.
Overlay the clinical scenario when testing.
Adding clinical details to the form helps the diagnostic laboratory.

Presenter

Alwyn D’Souza

Consultant Haematologist

Dr Alwyn D’Souza is a consultant haematologist at Capital & Coast District Health Board. He graduated from Otago School of Medicine in 1993. He did the majority of his post-graduate training in Wellington, before completing his training in Melbourne at the Royal Melbourne Hospital and Peter MacCallum Cancer Centre. He has worked at Wellington hospital as a consultant since 2006. His special areas of interest are haematopoietic stem cell transplantation (“bone marrow transplantation”), and lymphomas. He also has an interest in medical education and is the current chair of the NZ Joint Training Committee in haematology.