Case: A 3 year- old boy presented with weakness, pallor and gradually increasing abdominal girth. He was born with parents with no consanguineous marriage. He was delivered after full-term normal pregnancy. Development of the child was normal. The patient’s medical history was not significant. There was no history of easy bruising or prolonged bleeding on trauma, hematemesis, fever, night sweats, and weight loss or bone pains.
Physical Examination: Upon admission, the patient looked thin but not ill; he did not have the fever. On physical examination, pallor was noted; however, there was no icterus or lymphadenopathy. He had firm, nontender massive splenomegaly and a nontender, mild hepatomegaly (Figure1). There were no signs of ocular motor problems or other neurological abnormalities. Rest of systemic examination was essentially normal. Lab investigations: Bicytopenia (hemoglobin=8.5…
