Published in:
01-03-2019 | Neonatal Screening | Images in Hematology
A case of pancytopenia and hypercellular bone marrow: when family history can suggest the diagnosis
Authors:
Elena Fabbri, Roberta Pericoli, Beatrice Filippini, Pietro Gasperini, Marcello Stella, Gianluca Vergine
Published in:
International Journal of Hematology
|
Issue 3/2019
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Excerpt
A 12-month-old male Italian infant was admitted to another hospital for a 4-month history of weight loss (2 kg lost in 4 months) and feeding difficulties. At physical examination the child appeared pale, hyporeactive, and hypotonic. Liver and spleen were enlarged. His weight was below the third percentile for age. A significant delay in the developmental milestones and communicative reactions for age was noted. His blood exams revealed severe normocytic anemia (Hb 3.8 g/dL, MCV 83.2 fL), moderate neutropenia (710/µL) and mild thrombocytopenia (plts 111 × 103/µL). He received a packed red blood cell transfusion and was transferred to our onco-hematologic unit with a suspicion of lymphoproliferative disease. A blood sample taken after the red blood cell transfusion showed normal ferritin and iron values. The serum level of vitamin D was in the normal range, whereas lactic dehydrogenase plasma level was elevated (2500 U/L, normal value 120–300). …