Diagnostic Dilemma - Pediatric Oncall
Is it Wiskott Aldrich Syndrome_?
Author: Pediatric Oncall
A 6 years old boy presented with fever for 2 months and cough for 15 days. He had been treated for abdominal TB 2 years ago for 9 months. On examination, his weight was 16 kg. Other systems were normal. Hemogram showed hemoglobin of 10.3 gm, dl, WBC count of 9,600, cumm {40 percent polymorphs, 46 percent lymphocytes, 14 percent eosinophils} and platelets of 26,000, cumm. His Chest X-Ray showed bilateral basal and right perihilar haziness. CT chest showed multiple tiny nodular opacities in bilateral lung parenchyma with multiple small cavities in right upper lobe and hilar adenopathy suggestive of tuberculosis. His HIV ELISA was negative. He was started on 4 drug antituberculous therapy {ATT}. Two months later, his Chest X-Ray was normal but thrombocytopenia persisted. He was shifted to 2 drugs ATT. At end of 3 months, he developed atopic dermatitis with seborrheic dermatitis which responded to antihistamines and emollients. He was suspected to have Wiskott Aldrich syndrome {WAS} but MPV was decreased and bone marrow showed increased megakaryocytes. His serum immunoglobulins were also normal. At end of 6 months, ATT was stopped but platelets were still low. He then had malena which required platelet transfusion. His serum IgE was elevated {542 IU, L}.
Answers of this discussion
Author :- Hany EGYcas on 30 May 2012.
Answer :- most think its ITP

Author :- Ezra Lee Cole on 31 May 2012.
Answer :- Wiskott Aldrich Syndrome

Author :- sabin royca on 02 June 2012.
Answer :- wiscott alrdrich syndrome

Author :- khurram shahnawaz on 02 June 2012.
Answer :- ITP is thrombocytopenia in a well child....which i unlikely in this child. he is failing to thrive,thrombocytopenia,eczema and seems to be immunodeficient.... i will go for WAS in this case

Author :- AKJ Ahamedc on 02 June 2012.
Answer :- Idiopathic Thrombocytopenia

Author :- Nagla Elhag on 02 June 2012.
Answer :- Wiskott Aldrich Syndrome

Author :- fificash ad on 02 June 2012.
Answer :- This is most probably a case of Wiskot Aldrich syndrome

Author :- nivien khatab on 02 June 2012.
Answer :- it is itp

Author :- hbkcash adv on 03 June 2012.

Author :- Gunjan Bajaj on 03 June 2012.
Answer :- I think ITP

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