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Shematologist, MD

@acweyand

Oct 2, 2024

This is the story of a girl.

Of a family.

Of tragedy and a devastating disease.

It all starts in the Åland Islands, an autonomous, Swedish speaking region of Finland.

1/

Hjordis Sundblom was the 5th child of 11, born to Klas and Augusta.

At the time of her birth, her parents had already lost 3 daughters (Dagny, Dagny, and Anna) due to severe bleeding.

Both Dagnys had intestinal bleeding while Anna died after biting her tongue.

The bleeding went back several generations.

Augusta’s grandmother died from postpartum hemorrhage after her 7th pregnancy.

Augusta, her mother, and 4 of her 10 siblings all had excessive bleeding.

Klas’s family also had “bleeders”

Read 11 tweets

Shematologist, MD

@acweyand

Jan 18, 2024

https://twitter.com/cmclymer/status/1747692556538790142

Did you know there are sound biological reasons why incest is illegal?!

A 🧵

1/

https://twitter.com/cmclymer/status/1747692556538790142

Inbreeding, or mating with those genetically close to you, goes against the biological imperative of mating which is to shuffle DNA.

Certain congenital defects and diseases are inherited in a recessive manner, meaning you need 2 abnormal copies of a gene.
2/

Mating w/ someone that is genetically close to you vastly increases the chances you carry the same recessive genes.

One study showed that the rate of infant or childhood death nearly doubles in kids from first cousin unions.
3/

Read 6 tweets

Shematologist, MD

@acweyand

Nov 21, 2023

In hematology we often transfuse red blood cells and platelets for a number of different conditions.

But what about neutrophils?

A short Schitts Creek themed tweetorial thread 🧵

1/

Turns out granulocyte infusions are a thing but there are many reasons why you haven’t likely heard of or used them.

They’re typically used when pt
🩸is very neutropenic
🩸has severe bacterial or fungal infxn unresponsive to antimicrobials
🩸marrow recovery is expected.
2/

But giving granulocytes is tricky.

🩸they start to lose function ~6 hrs & shelf life is 24 hrs
🩸infectious donor testing typically takes 24-48 hrs
🩸contain RBCs so must be ABO/Rh compatible
🩸CMV neg pts need CMV neg cells
🩸donors must be stimulated for collection
3/

Read 7 tweets

Shematologist, MD

@acweyand

Aug 3, 2023

Our recent study found that nearly 40% (!) of 12-21 yo females are iron deficient.

But did you know that in addition to many physical symptoms, iron deficiency is associated with multiple mental health issues?

A #tweetorial 🧵1/tinyurl.com/FeJAMA

It is estimated that ~400 genes (~2% of genome) are involved in iron metabolism & homeostasis.

In addition to irons role in erythropoiesis (making red blood cells), iron participates in energy production & electron transport, cell metabolism, respiration, proliferation..

2/

& differentiation, regulation of gene expression & synthesis of nucleus acids & proteins.

Iron is also the cofactor of aromatic amino acid hydroxylases!

The activity of these enzymes is the limiting step in the synthesis of dopamine, serotonin and norepinephrine

3/

Read 12 tweets

Shematologist, MD

@acweyand

Jul 5, 2023

We recently found that almost 40% (!) of “healthy” 12-21 year olds have iron deficiency.

But only ~6% were anemic so who cares?!

I do, and you should too.

A #hemetweetorial 🧵 1/tinyurl.com/FeJAMA

First of all we used @WHO definition of anemia which is sexist & not supported by evidence.

The study used to support this cutoff found that when women were given iron the lower limit of normal ⬆️to ~that of men.

So 6% is likely an underestimate. 2/
tinyurl.com/Sexspecificane…

But the bigger point is that iron deficiency matters OUTSIDE of anemia.

Studies have shown ID can cause fatigue, ⬇️ concentration, dizziness, tinnitus, pallor, headache, alopecia, sleep disorders esp restless legs, pica & more. 3/

tinyurl.com/IronDefPasricha

Read 8 tweets

Shematologist, MD

@acweyand

Apr 16, 2023

Let’s talk about beautiful things.

Janelle Monae & blood cells.

An erythrocyte.

An eosinophil.

A platelet.

Read 8 tweets

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