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Alphabet Soup - Challenging Consults on the Pediatric Units

Program: Education Program
Hematology Disease Topics & Pathways:
Clinical Practice (Health Services and Quality), Workforce, pediatric, Biological Processes, Study Population, Human
Monday, December 11, 2023: 4:30 PM-5:45 PM
Room 11 (San Diego Convention Center)

Description:
Identifying a rare or complex disorder that may have various non-specific clinical and/or laboratory findings can be difficult in a pediatric patient. Early recognition and the ability to make a diagnosis can often be critical for the management of many of these types of conditions. This session will review some of the more challenging “alphabet soup” diagnoses that the pediatric hematologist/oncologist faces when doing consults on a pediatric inpatient unit. Talks will focus on when to consider certain complex illnesses and distinguishing between related disorders that may have similar presentations and will provide up to date reviews of appropriate work-up and management of these disorders.

Dr. Kumar will address the challenges in making the diagnosis of hemophagocytic lymphohistiocytosis (HLH). He will highlight the pitfalls in currently available diagnostic approaches and discuss newer, more reliable methods to diagnose primary HLH, and to differentiate HLH from its various mimics such as infections and malignancies.

Dr. Nicole Kucine will discuss leukocytosis in young children with a focus on myeloproliferative disorders unique to infancy and early childhood. She will review the presentation and differential diagnosis of young children with myeloid proliferation, focusing on transient abnormal myelopoiesis in infants with Trisomy 21 and juvenile myelomonocytic leukemia in infants and young children, as well as associated disorders, and will outline the process for their evaluation.

Dr. Takemoto will focus on consumptive thrombocytopenia due to immune and non-immune causes.  The diagnosis and management of heparin induced thrombocytopenia in children will be reviewed.  In addition, clinical and laboratory features of microangiopathic hemolytic anemias will be discussed, as well as approaches to the diagnosis of disseminated intravascular coagulation, thrombotic thrombocytopenia purpura, and other thrombotic microangiopathies.

Chair:
Nicole Kucine, MD, MS, Weill Cornell Medical College
Disclosures:
Kucine: PharmaEssentia: Consultancy; Protagonist Therapeutics: Consultancy.
Identifying a rare or complex disorder that may have various non-specific clinical and/or laboratory findings can be difficult in a pediatric patient. Early recognition and the ability to make a diagnosis can often be critical for the management of many of these types of conditions. This session will review some of the more challenging “alphabet soup” diagnoses that the pediatric hematologist/oncologist faces when doing consults on a pediatric inpatient unit. Talks will focus on when to consider certain complex illnesses and distinguishing between related disorders that may have similar presentations and will provide up to date reviews of appropriate work-up and management of these disorders.

Dr. Kumar will address the challenges in making the diagnosis of hemophagocytic lymphohistiocytosis (HLH). He will highlight the pitfalls in currently available diagnostic approaches and discuss newer, more reliable methods to diagnose primary HLH, and to differentiate HLH from its various mimics such as infections and malignancies.

Dr. Nicole Kucine will discuss leukocytosis in young children with a focus on myeloproliferative disorders unique to infancy and early childhood. She will review the presentation and differential diagnosis of young children with myeloid proliferation, focusing on transient abnormal myelopoiesis in infants with Trisomy 21 and juvenile myelomonocytic leukemia in infants and young children, as well as associated disorders, and will outline the process for their evaluation.

Dr. Takemoto will focus on consumptive thrombocytopenia due to immune and non-immune causes.  The diagnosis and management of heparin induced thrombocytopenia in children will be reviewed.  In addition, clinical and laboratory features of microangiopathic hemolytic anemias will be discussed, as well as approaches to the diagnosis of disseminated intravascular coagulation, thrombotic thrombocytopenia purpura, and other thrombotic microangiopathies.

Ashish Kumar, MD

Cincinnati Children's Hospital Medical Center, Cincinnati, OH

Nicole Kucine, MD, MS

Weill Cornell Medical College, New York, NY

Clifford M Takemoto, MD

St Jude Children's Research Hospital, Memphis, TN

See more of: Education Program