Congenital leukaemia

A boy of 14 days admitted in the Neonatal ward of our hospital with fever, respiratory distress, rash and abdominal distention.

On close examinatin, the rashes were found to be purpura and ecchymosis; the lung has bilateral crepitations, the abdomen is distended for hepatospenomegaly.

On clinical imprestion it was first thought to be a case of Neonatal Sepsis. The next possibility is Torch Infection.

But the blood count reveals Hb-5.3 gm/dl, TC of WBC -1,600,000 /cmm, 90 of them are blast cells, peripheral blood film study reveals them as lymphoblasts.

So the diagnosis was lebelled as Congenital Acute Lymphobalstic Leukaemia.


Bdoza

ITP with purpura and subconjuctival haemorrhage

ITP with pupura and subconjunctival Haemorrahge

A girl of 6 years presented with 5 days fever, subconjuctival haemoorage and skin rashes.
The patient was also giving the history of passage of stool mixed with altered or fresh blood and also passage of reddish urine.

On examination, the patient was alert and conscious, non toxic, the rashes were identified as purpura present all over the body. There was mild hepatomegaly. but no splenomegaly no lymophadenopathy and no bony tenderness.

Clinically we suspect the case as ITP or Dengue fever, or Laukaemia

Though at present, there is no epidemiological evidence for Dengue, we wanted to exclude the Dengue as the rainy season begins in our country. But though platelet count was 50000/cmm, But the PCV was 38% and antibodies against the Dengue were absent.

The other features of peripheral blood pictures are normal. We were preparing for bone marrow aspiration.

In the meantime , pt was start improving, her bleeding stops, there was no further crops of purpura, no epistaxis, no malean and no hematuria.

The fever may be a coinfection on ITP.

Bdoza