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International Journal of Hematology

, Volume 109, Issue 3, pp 243–244 | Cite as

A case of pancytopenia and hypercellular bone marrow: when family history can suggest the diagnosis

  • Elena Fabbri
  • Roberta Pericoli
  • Beatrice Filippini
  • Pietro Gasperini
  • Marcello Stella
  • Gianluca VergineEmail author
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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).

Repeating the exams a few days later, we...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this paper.

References

  1. 1.
    Briani C, Dalla Torre C, Citton V, Manara R, Pompanin S, Binotto G, et al. Cobalamin deficiency: clinical picture and radiological findings. Nutrients. 2013;5:4521–39.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Guez S, Chiarelli G, Menni F, Salera S, Principi N, Esposito S. Severe vitamin B12 deficiency in an exclusively breastfed 5-month-old Italian infant born to a mother receiving multivitamin supplementation during pregnancy. BMC Pediatr 2012;12:85.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Özkale M, Sipahi T. Hematologic and bone marrow changes in children with protein-energy malnutrition. Pediatr Hematol Oncol. 201431(4):349–58.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Society of Hematology 2019

Authors and Affiliations

  • Elena Fabbri
    • 1
  • Roberta Pericoli
    • 1
  • Beatrice Filippini
    • 1
  • Pietro Gasperini
    • 1
  • Marcello Stella
    • 2
  • Gianluca Vergine
    • 1
    Email author
  1. 1.Department of PediatricsInfermi Hospital RiminiRiminiItaly
  2. 2.Department of PediatricsBufalini Hospital CesenaCesenaItaly

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