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

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

He is not affordable it seems to be


Less likely

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Get a cbc with gbp atleast.

It is there sir

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

Haemolytic Anemia.

Sickle cell anaemia,cml ,thalesaemia

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