Question of the Week

Question :
Q. A 4-year-old boy came with progressive distention of the abdomen and fever. He has pallor, massive splenomegaly up to the umbilicus, and mild hepatomegaly. Hb 4.4 tlc 3400 platelet 40000, gbp-microcytic hypochromic anemia. PS for mp negative. How should I approach this case? No lymphadenopathy.

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Answer Discussion :
H
hizbullah khan
im
Get his peripheral smear ..
R/O infective etiology (leishmania, Brucellosis )
AIHAs..
Look for Malignancy (leukemia, lymphoma)
Metabolic work for Gaucher's disease for isolated massive splenomegaly (not urgent)

H
Hazrat bilal Khan
im
r/o
leishminiasis
brucellosis
tropical splenomegaly
HIV Screen
and lastly HLH..

Basic point is the patient is from india/south east asia where we consider infection at top....
so go for Retic count
BMBiopsy ,even splenic biopsy more straightforward approach

23 hours ago

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