May 2010 Volume-7 Issue-5 [Supplement 5]
(ISSN - 0973-0958)
DIAGNOSTIC DILEMMA
A 9 year old girl presented with recurrent cough with copious sputum since 1 year of age. She had joint pains with morning stiffness since 6 months. She was hospitalized for pneumonia at 3 years of age, hepatitis at 3½ years of age, malaria at 4 years of age, chickenpox at 6½ years of age. She was treated with antituberculous therapy at 3 years of age for 6 months. On examination, she had microcephaly, was short and had sloping forehead with parrot shaped nose. She had bilateral coarse crepitations with mild hepatosplenomegaly. What is the diagnosis?
A 7 years old girl presented with recurrent episodes of cough and cold for the past 2 years. Cold may persist even longer up to 2 weeks sometimes. Symptoms are worse in spring. Symptoms always start with cold followed by itchy feeling in the throat. She gets relieved with treatment {anti-histamines}. Father has allergy to dust and maternal grandmother is on inhalers for asthma. On examination, she is a mouth breather. She has an erythematous oropharynx, hypertrophied nasal turbinates and serous rhinorrhea. What is the diagnosis?
Balu Athreya
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This 20 months old boy presented with history of pallor for long time, he was given iron therapy for about 3 months after doing hemoglobin and found it 8.5 gm/dl. Now his CBC is Hemoglobin is 10, HCT 33, MCV 77, MCH 23, Reticulocytes 1.1, RDW 12.7, PLT 346,000, WBC 7,000. Is it still iron deficiency? Why it was not corrected after iron therapy {proper dose} and why the reticulocyte count isn't increasing?
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