Discover and read the best of Twitter Threads about #heme

Most recents (4)

Let me start with #insulin. In the 1970s, insulin was extracted from the pancreas of animals. In the 1980s, @Genentech, working with Eli Lilly (@LillyPad), developed insulin using a new technology that I call #PrecisionFermentation. It wasn’t animal insulin. It was human insulin.
The mainstream would say: “health care is slow, it can’t be disrupted.”

Well, here’s the S-curve of #PrecisionFermentation human insulin. Human insulin disrupted animal insulin in about 13 years.
#PrecisionFermentation is a concept that I coined in my @rethink_x report ‘Rethinking Food and Agriculture’ with @CatherineTubb in September 2019.
Read 30 tweets
Now for an update on #TTP -- always a disease I enjoy teaching about -- the pathophysiology combines so much #heme goodness. Also, I always enjoy the summary slide up front from Dr. George. #ASPHO2021 1/n
For those studying for boards in the future... this is the classic TTP blood smear! #mededpearls #TTP #ADAMTS13 #ASPHO2021 2/n
Hereditary TTP management summarized here -- nice to have it on one slide! 3/n
Read 5 tweets
Summary of cytoplasm/nucleus changes in leukocytes:
1️⃣ Hyposegmentation of neutrophils(peanut shaped, bilobed,or non-segmented nucleus with coarse chromatin)
🔬associations: Pelger–Huët anomaly(inherited) or pseudo-Pelger–Huët anomaly(acquired)

#MedTwitter @ASH_hematology #Heme ImageImageImage
➡️Pelger–Huët anomaly(inherited):affect majority of granulocytes: autosomal dominant- mutations in the lamin B receptor gene
➡️Pseudo-Pelger–Huët anomaly(acquired): <50% of granulocytes: usually occurs with other morphological changes of malignancy: can see in MPNs or MDS
#Heme Image
2️⃣Hypersegmentation of neutrophils
➡️≥ 6 lobes in granulocyte nucleus
🔬associations: megaloblastic anemia, chronic infections, MDS, familial(rare)
#Heme ImageImage
Read 8 tweets
1/ Can hemolytic anemia exist with no reticulocytosis?

Incoming #MedTwitter #Tweetorial #HemOnc #heme #hematology
2/ We've all been taught that hemolysis and hemorrhage are accompanied by a compensatory marrow response which leads to reticulocytosis and a slight increase in MCV (reticulocytes are larger than your average RBC).
But what if hemolysis co-existed with reticulocytopenia?
3/ A 46 y.o. M with no significant PMH and PSH presented after he noticed a change in his urine color (darker) for the past wk. He mentions that the last 2 times he tried to donate blood in the past year, he was told he was too anemic to donate. Prior to this, no issues donating.
Read 26 tweets

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