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Question

My patient is 8 years old and male. He presented to us with high fever, generalized lymphadenopathy, hepatosplenomegaly and purpura. Platelet count is 500,00/cmm with normal TLC and DC. His bone marrow study is normal. He also has hematuria. FDP is normal. What is the most likely diagnosis?

Answer

What are his renal function tests? Is the hematuria due to hemoglobinuria or myoglobinuria or were RBCS seen in the urine.
Since bone marrow is normal, one may have to consider a diagnosis of Hemolytic uremic syndrome/ Thrombotic thrombocytoenic purpura (though FDP is normal). What are the LDH, SGOT? If myoglobinuria is present, rule out viral infections such as dengue and viral hemorrhagic fever.
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