This 16 yr male boy came to our opd with severe pallor with splenohepatomegaly ( spleen 8cm bcm liver 4 cm bcm) with off and on fever negative for malaria and kala azar( K 39) what could be possible diagnosis and management pt is very poor we can't afford many investigation no prior transfusion history

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Malaria cmll thalasemia lymphoproliferative disease histocytosis x

Do LFT if affordable.Otherwise give iron I.V.Infusions

LFT is attached sir
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HB electrophoresis to rule out hemolytic anemia... Tsb is raised.. hemolytic facies can be seen

He is not affordable it seems to be
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Thalassemia

Less likely
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Get a cbc with gbp atleast.

It is there sir
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Any history of previous blood transfusion , by family history Facial features look alike hemolytic face Other' pointer in favour of hemolytic is increased value of serum bilirubin

Microcytic , hypochromic pictures in smear

Chronic hemo, lytic anaemia. Do HPLC, iron study, bone marrow study.

Iron study done showing decrease serum ferritin with increased TIBC
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Haemolytic Anemia.

Sickle cell anaemia,cml ,thalesaemia

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