|
A
4-year-old girl is brought by her parents to hospital with a history of
pallor, bruising and lethargy. On examination, she has a temperature of
38 °C, heart rate 110 Beat per minute, BP 100/60. She is pale, and has
multiple bruises over her arms and legs. She has extensive lymphadenopathy.
Cardiovascular and respiratory examinations are within normal limits.
She has 4 cm hepatomegaly, and 3 cm splenomegaly.
A
full blood count shows:
|
Hb
|
6.9
g/dl
|
|
WCC
|
189
× 109/l
|
|
Neutrophils
|
1.3
× 109/l
|
|
Lymphocytes
|
185
× 109/l
|
|
Platelets
|
28
× 109/l
|
|
The
blood film shows blasts
|
|
