Concluded Case

How we proceed?

A 36 months old girl presented in out-door department with fever, severe back pain, difficulty in sitting and walking due to pain. Examination revealed pallor and generalized bony tenderness. Complete blood count showed anaemia (7.4 gm/dL) and normal counts (TC - 10,400 with 58% lymphocytes). A skeletal survey by radiography was done, which demonstrated extensive lytic lesions involving the skull, spine, visualized ribs, bilateral scapula, humerus, iliac bones, femur and tibia. DDx? How we approach ?

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Concluded answer
Complete hemogram followed by s bone marrow examination to be done.Multiple lytic lesion at this age.Case may be langerhan cell histiocytosis as one possibility.
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Possible diagnosis is Gorham-Stout disease. Rare bone disorder. Usually clinical diagnosis Supportive CT or MRI. Multidisciplinary approach in management is required. Radition therapy Interferon alfa 2 b Bisphosphonates Sirilimus Are preferred options.
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Complete hemogram followed by s bone marrow examination to be done.Multiple lytic lesion at this age.Case may be langerhan cell histiocytosis as one possibility.
Osteolytic bone tumor ? Giant cell tumor, fibrous dysplasia ??
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