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Question

4 years female presentd with sudden attack of fever,loose motion.NoF\H of favism,or blood transfusion. O\E:GC is good, she has striking pallor,no icterus ,no hepatosplenomegaly,no significant lymphglands. lab.values:HBg 6g%, Ret.count 10% ,normocytic hypochromic blood picture,normal platelet count,no hemoglobinuria ,no blood in the stool.what further suggestions to reach diagnosis.

Answer

Since her retic count is high, one needs to rule out hemolysis be it autoimmune hemolytic anemia, malaria, enzyme defects like pyruvate kinase deficiency. Also bleeding should be ruled out as in dengue fever or viral hemorrhagic fever.
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