Haematology Outpatient Clinic

Pavilion 8 (Central Laboratories)

The Haematology Outpatient Clinic for adult patients with blood disorders provides diagnostic and therapeutic care for patients with blood disorders, with the exception of those requiring high-dose chemotherapy and admission to a specialist haematology inpatient ward. It provides a consultation service in the fields of haematology and transfusion medicine. It collaborates with haematology units offering inpatient care.

Outpatient clinic opening hours
Mon and Tue 7.30–18.00 (last patient admitted at 17.00)
Wed–Fri 7.30–15.30
Autologous blood collection
Fri 8.00–12.00

Bookings (patients from Prague 8; 9, Prague – East) can be made by telephone on +420 266 082 403 (ideally on weekdays between 14.00 and 15.00) or by email:&hematologie@bulovka.cz

To book an appointment for new patients, the following must be provided

referral forms
laboratory results and imaging scan results
a brief medical history, including any medication currently being taken

Once the doctor has assessed the documentation provided, the patient will be contacted with the date of the examination.

Patients requiring haematological investigations as a matter of urgency or on a priority basis (the waiting time for an initial examination can range from 3 to 6 months), are accepted following telephone consultation with the referring doctor, who will contact the haematology consultant. Contact can be made via the FNB switchboard on +420 266 081 111.

For GPs and specialists:

Due to capacity constraints, please first rule out any non-haematological causes of the symptoms.

Here we provide a basic differential diagnosis of the most common blood abnormalities, including the required tests.

Anaemia

Low MCV

Assessment of iron metabolism (ferritin, transferrin, transferrin saturation and total iron-binding capacity), vitamin B12 and folate levels to rule out a combined deficiency,
If iron deficiency is confirmed (low ferritin level, high iron-binding capacity, low transferrin saturation), iron replacement therapy is indicated
- depending on the severity of the anaemia and tolerance, approximately 150 – 200 mg Fe per day in a preparation,
- for greater efficacy, it is advisable to prioritise preparations containing iron in the form of sulphate (Sorbifer/Tardyferon),
- once Hb levels have stabilised, in milder forms of anaemia and in cases of iron intolerance, it is preferable to administer the dose every other day;
- to maintain adequate stores, we recommend continuing iron replacement until ferritin levels reach approximately 40–50 mcg/l.
For every patient, it is essential to identify the source of blood loss prior to the initial haematological examination (endoscopic examination of the gastrointestinal tract, ruling out haematuria, and, where necessary, a gynaecological examination).

In cases of confirmed iron deficiency, we only accept patients for haematological examination if they are suspected of having an iron absorption disorder.

We accept patients with oral iron intolerance and patients with a source of bleeding that has not yet been identified following consultation by telephone with the referring doctor.

High/normal MCV

Testing of vitamin B12 and folic acid levels (if vitamin B12 levels are low, a gastroscopy is performed to rule out atrophic gastritis); testing of iron metabolism to rule out a combined deficiency.
Microscopic examination of the differential white blood cell count.
Ruling out haemolysis (elevated bilirubin, LDH, reticulocytosis).
Ruling out secondary causes – basic biochemistry, TSH, cancer screening (abdominal ultrasound, chest X-ray, TOKS, endoscopy if necessary, PSA level/gynaecological examination + mammogram).

Leukopenia

Microscopic examination of the differential white blood cell count.
Ruling out secondary causes (infectious/oncological/autoimmune diseases – basic biochemistry, cancer screening: abdominal ultrasound, chest X-ray, TOKS, PSA level/gynaecological examination + mammogram).
Consideration of the effect of medication.

Thrombocytopenia

Rule out pseudothrombocytopenia (platelet clumps reported in the complete blood count) by collecting a sample in a medium without EDTA (e.g. TromboExact).
Microscopic examination of the differential white blood cell count.
Rule out secondary causes (infectious/oncological/autoimmune diseases – basic biochemistry, cancer screening: abdominal ultrasound, chest X-ray, TOKS, and possibly endoscopy, PSA level/gynaecological examination + mammogram).
Consider the influence of medication.

Leucocytosis

Microscopic examination of the differential white blood cell count.
Ruling out the influence of medication (corticosteroids).
Ruling out secondary causes (infectious/oncological/autoimmune diseases – basic biochemistry, CRP, cancer screening: abdominal ultrasound, chest X-ray, TOKS, possibly endoscopy, PSA level/gynaecological examination + mammogram).

Mild, stable leukocytosis without abnormalities in the microscopic differential count of white blood cells may be associated with obesity or smoking.

Thrombocytosis

Ruling out secondary causes (infectious/oncological/autoimmune diseases – basic biochemistry, CRP, cancer screening: abdominal ultrasound, chest X-ray, TOKS, or endoscopy if necessary, PSA level/gynaecological examination + mammogram).
Rule out iron deficiency (see Anaemia: low MCV).

Polycythaemia

Ruling out cardiac or pulmonary disease (chest X-ray, cardiological/pulmonary examination) and secondary polycythaemia in smokers.
Ruling out cancer of the liver and kidneys (abdominal ultrasound).
If sleep apnoea syndrome is suspected, a sleep study in a sleep laboratory.
Ruling out iron overload (transferrin saturation, ferritin).
SGLT2 inhibitors may cause polycaemia – consider alternative medication.

We admit patients with secondary polycaemia following telephone consultation with their GP or specialist for therapeutic venepuncture.