Non-Hodgkin’s lymphoma can be associated with an autoimmune haemolytic anaemia causing recurrent episodes of haemolysis, giving rise to problems in a slowly progressive low grade lymphoma. Managing such a patient can be a challenge. We report such a patient who refuses transfusion of blood products for religious reasons, which makes the challenge even more impossible to manage. This case highlights how this situation was managed successfully with available, less aggressive therapy.

Upper extremities deep venous thrombosis (UEDVT) is less frequent than lower limb DVT but the incidence of UEDVT may be increased in patients affected by malignancies and bearing central venous catheters (CVC) or other devices as peripherally inserted central catheters (PICC). The standard of care for the treatment of cancer-related venous thromboembolism has been low molecular weight heparin (LMWH) for several years. But treatment with direct oral anticoagulants (DOACs) may represent an alternative to LMWH in patients with cancer related VTE. In the present article, we report a case of a 49 year old man with colorectal cancer in treatment with chemotherapy who presented DVT of the upper left limb with involvement of subclavian-axillar venous axis. Patient was treated with edoxaban 60 mg following a few days of LMWH (i.e., 100 u/kg twice daily). After three months, a vascular ultrasound scan showed the disappearance of DVT with a full recanalization of the vessel.

Background: Multiple alloantibodies in patients’ sera present with widely variable reaction strengths and matching patterns. Therefore, from an immuno-haematologists’ point of view, alloantibodies once detected in antenatal or pre-transfusion setting, must be confirmed for their specificity and clinical significance. Case report: We report herein the case of a 57-year old female patient admitted in our hospital with chief complaints of breathlessness and mild grade fever. She was a known case of Type II diabetes mellitus with endstage renal disease. Her requisition for one pint of packed red blood cell (PRBC) was received at our department for pre-transfusion compatibility test and subsequent issue of blood. During immunohematology work-up, her blood type was found to be B Rh D Positive. However, her sera showed incompatibility with random B Rh D positive PRBC units. Her indirect coombs test was positive. The reactivity pattern in an eleven cell identification panel (Biorad, Switzerland) showed variable pattern and suggested of antibody/s against E and c antigen specificity. We subsequently issued one B Rh D positive (E and c antigen negative) anti-human globulin cross-matched compatible PRBC to the patient. We also issued an antibody card for her future reference. Conclusion: Transfusion of phenotypically matched PRBC for the implicated E and c compared to that phenotypically matched for the standard ABO-D System could help save patient from adverse transfusion event/s. Knowledge of multiple alloantibodies can assist in selecting appropriate transfusion strategy for the patient/s. In addition, requisite skill and precision is always desirable when dealing with multiple allo-antibodies because they can directly influence patient’s clinical outcome.

The alteration of haemostasis during bacterial infection and sepsis are well known. Several mechanisms have been described in last decades and may lead toward disseminated intravascular coagulation. Here we report most common mechanisms that may be treated from a clinical point of view during a bacterial sepsis.

Active treatment of acute venous thromboembolism without active bleeding is primarily based on the administration of LMWH, according to international guidelines. However, recent studies have provided data on direct oral anticoagulants that offer interesting new perspectives concerning efficacy in the prevention of recurrent VTE and the safety of these drugs in this particular patient population.