Premature infant with anemia and hyperbilirubinemia
Description
-
The patient is a 10-day-old male born at 27 weeks with history of fetal anemia and hydrops, for which he underwent percutaneous umbilical cord blood sampling (PUBS) and received three blood transfusions prenatally. His postnatal course has been complicated by persistent anemia and thrombocytopenia.
Initial laboratory results were as follows:
- CBC: Hgb 7.6 g/dL, WBC 13.5x109/mcL, platelets 220x109/mcL, MCV 80.2 fL, RDW 17.4%
- Reticulocyte count: 0.4%
- LFTs: bilirubin 6.8 mg/dL, indirect bili 5.7 mg/dL, direct bili 1.1 mg/dL
- Cr: 1.44 mg/dL
- Infant blood type: A+
He had a history of hyperbilirubinemia following birth that required phototherapy for 3 days.
He continued to have persistent anemia with reticulocytopenia and was transfusion dependent for several months.
Based on the clinical presentation and laboratory evaluation, what is your leading differential diagnosis for his anemia?
Take the quizJulia Leix, MD, Randy Windreich, MD; Erika Friehling, MD MS
Division of Pediatric Hematology Oncology & BMT, UPMC Children's Hospital of Pittsburgh
Pittsburgh, PA Associations
-
- Details
- Categories: Case Quiz