Shahnaz Iftikhar.
Congenital Leukemia.
Pak Paed J Jan ;19(1):33.

A 9 days old baby was brought by the parents with the complaints of jaundice, fever of four days duration and purpuric spots on the thighs and chest that were noticed some days back. On examination, baby was not looking pale, spleen was firm and reaching the left iliac fossa, liver was 3 cm palpable below the costal margin but the lymph nodes were not palpable. There are nodular skin lesions on the chest and abdomen ranging from 1-3 cm size. Lab findings include: Hb 12gm, ESR 40, TLC 1,40,000/cmm, Platelet count=80,0000/cmm. Differential leukocyte count showed blast cells 80%, polymorphs 10%. Bone marrow examination showed hyperplastic smears and fragments. Myelopoiesis was hypoplastic with few stages of maturation. Erythropoiesis was hypoplastic and normoblastic; megakaryocytes and platelets were reduced in number; lymphocytes and plasma cells were not increased. Bone marrow was infiltrated with blast cells with large open chromatin network nuclei containing 2-3 nucleoli and abundant grayish blue cytoplasm. The findings were diagnostic of acute leukemia.

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