Diagnostic Dilemma

Acute hemolysis

A twelve years old male child born of third degree consanguineous marriage presented with fever for 10 days and high colored urine for 5 days. On examination, he had pallor, icterus and splenohepatomegaly. He had bradycardia and basal crepitations suggestive of congestive cardiac failure. He had been treated with Chloroquine 5 days ago along with Primaquine by a private practitioner for his fever. A clinical diagnosis of pyrexia with acute hemolysis was considered. His hemoglobin was 4.4 gm% with a WBC count of 10,400/cumm and platelet count of 4,72,000/cumm. Reticulocyte count was 5.1% with corrected reticulocyte count of 1.7%. Serum bilirubin was 1.5 mg/dl with indirect bilirubin of 0.9 mg/dl. Liver enzymes were normal with direct coombs test and indirect coombs test being negative. The child did not have any further fever in the hospital stay.

What is the cause of hemolysis?
Answer Discussion :
Ebtihal Khalid
drug induced with G6PD deficiency
9 hours ago
amanj mikaeel
malaria infestation
1 Day ago

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