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25th July 2024
An 88-year-old gentleman with end-stage metastatic prostate cancer presents with a purpuric rash
An 88-year-old gentleman with end-stage metastatic prostate cancer presents with a purpuric rash and bleeding from his gums. He regularly attends the day unit for RBC and platelet transfusions due to intermittent issues with bleeding. He is known to have extensive bony metastases and has a degree of bone marrow failure secondary to this.
Bloods on admission:
| Hb (130 – 180 g/L) | 92 g/L |
| WCC (3.6 – 11.0 x 10⁹/L) | 3.5 x10⁹/L |
| Platelets (140 – 400 x10⁹/L) | 7 x10⁹/L |
Bloods post platelet transfusion:
| Hb (130 – 180 g/L) | 93 g/L |
| WCC (3.6 – 11.0 x 10⁹/L) | 3.7 x10⁹/L |
| Platelets (140 – 400 x10⁹/L) | 9 x10⁹/L |
What investigation would be most appropriate to find the underlying problem with the transfusion?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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