Haematology

Iron infusion is a procedure by which iron is supplied to your body intravenously, into a vein via a needle. Iron infusions are usually prescribed by doctors to treat anaemia in cases where the iron deficiency is due to one of the following: 

• Can’t take iron by mouth 
• Can’t absorb iron sufficiently through the gut 
• Can’t absorb enough iron due to blood loss 
• Need to increase iron levels fast to avoid medical complications or a blood transfusion 

This therapy can help people with weakened immune systems or other diseases fight off infections. Some of the diseases that intravenous immunoglobulin (IVIg) can treat include: 

• Immune deficiencies like immune thrombocytopenia 
• Chronic inflammatory demyelinating polyneuropathy 
• Lupus 
• Myositis 
• Other rare diseases 
• People who receive bone marrow transplants may also use IVIg to prevent infections. 

Usually, infusions are periodically e.g. four weeks to keep your immune system strong. Your blood may break down about half of the immunoglobulin over that period, so you'll need another dose to keep fighting infections. 

If a patient is referred to the service for abnormal bloodwork, it can often require ongoing, periodic review for monitoring in the outpatient setting. Common abnormal blood work would include: 

• Low vitamin B12 
• Low neutrophils  
• Low / high white cell count 
• Low / high haemaglobin  
• Low / high iron 
• Low / high ferritin  
• INR warfarin management  
• Other specialised parameters / markers such as paraprotein  

Bone marrow biopsy is a procedure to collect and examine bone marrow — the spongy tissue inside some of your larger bones. It can show whether your bone marrow is healthy and making normal amounts of blood cells. Doctors use these procedures to diagnose and monitor blood and marrow diseases, including some cancers, as well as fevers of unknown origin. 

Your doctor may order a bone marrow biopsy to: 

• Diagnose a disease or condition involving the bone marrow or blood cells 
• Determine the stage or progression of a disease 
• Determine whether iron levels are adequate 
• Monitor treatment of a disease 
• Investigate a fever of unknown origin 

Therapeutic phlebotomy involves drawing blood to treat a medical problem such as hereditary haemochromatosis (having too much iron in your blood). Other conditions that can be treated with therapeutic venesection include  

• Polycythaemia – a rare blood cancer in which bone marrow produces too many red blood cells causing itching, bruising, bloating, abdominal pain, fatigue, headache, joint pain and swelling, nosebleeds and difficulty in breathing 
• Erythrocytosis -  a condition in which your body makes too many red blood cells (RBCs) or erythrocytes causing your blood to be thicker than normal and leading to blood clots (thrombosis) and other complications.  
• Porphyria cutanea tarda (PCT) in which porphyrins produced in excess by the liver, accumulate in the body and cause the skin to become sensitive to light.  

Venesection is generally well tolerated and reduces morbidity in these conditions. 

Venesection clinics take place in Mater Private Dublin every Wednesday.  

A full work up is when there is clinical indication that warrants further diagnostics to rule out or treat potential disease. A haematology full work up usually includes a range of blood tests, scans, MRI(s) and a bone marrow biopsy. 

Referral on to other services if clinically indicated.

New patient haematology clinics are held in Mater Private Dublin weekly on a Friday.