A case study is a standard format for recounting the story of a specific case. A case study should have the following format:
Case History
Begin by describing the way in which the patient came to be seen by a doctor. Describe their symptoms, history and some haematological results. In cases where clinical details are elaborate, you may want to simplify them to ensure your audience can understand. You can use tables to present data. Then go on to describe the haematological abnormalities and what they mean. Give
the diagnosis and explain how this was decided upon - are there any other conditions which could give rise to the patient's symptoms? How could the diagnosis be confirmed by other tests?
If the patient underwent any treatment, describe this. Why was this treatment selected?
Case study:
A 28 year old woman was visited by her GP. She had been complaining of general malaise for some days, and now appeared flushed and was sweating. She had developed several bruises over her body without, apparently, any significant cause. She was very agitated.
On examination, her GP found that she had an oral temperature of 39.4oC, and a heartbeat of 115 beats a minute. Although flushed, her nails were pale, and she had widespread bruising. Examination of her oral cavity revealed ulceration, a gum infection and some gum bleeding. The GP arranged for her to be taken urgently for admission to hospital under the care of the consultant haematologist. In hospital, the patient had samples of blood taken for full blood count (FBC), clotting screen and for blood grouping.
Blood film analysis
A Biomedical Scientist made a blood film and stained it. She then examined the blood film and reported the following:-
Red cells showed varying cell shapes and sizes. Occasional nucleated red blood cells were seen. Occasional red cell fragments were seen. Marked thrombocytopaenia.
A manual differential white blood cell count was performed by this biomedical scientist, with the following results (overleaf):-
Neutrophils 2% of white cells
Lymphocytes 17% "
Monocytes 1% "
Myelocytes 19% "
Promyelocytes 59% "
Blast cells 2% "
The biomedical scientist contacted the consultant haematologist to let her know the results from the FBC and clotting tests. The consultant then came to the lab to scan the blood film herself and made the following blood film comments:-
Many promyelocytes seen with azurophilic granules and bundles of Auer rods.
Blood group test results
She was found to be O Rhesus (D) positive, with no atypical antibodies present.
Initial treatment of patient
The consultant haematologist contacted staff in the Blood Transfusion department, and requested that 1 unit of platelets, and 4 units of FFP be given that evening to the patient. Antibiotics (gentomycin and meropenem) were started too, along with 'ATRA'.
Questions related to case study
Describe the disease itself - incidence, clinical features, likely progression, typical haematological presentation etc.
Describe the cause of the disease and any biochemical pathways involved. Why do the haematological abnormalities described occur?
Describe the treatment options available and the likely outcome for these patients.
Is there any research currently taking place in this field / are there any future developments likely?