Case presentation A 15-year-old boy presented to a GP with complaints of fatigue, breathlessness, and leg pain for the last few weeks. The patient’s parents reported that their son had paleness and a whitish sclera over the previous two years. Although the patient was a vegetarian, his family rarely had fresh fruits and vegetables in their daily diet.
Recent medical history About 15 days before the presentation, the patient suffered from an upper respiratory tract that resolved a week later. Physical examination Pale, icteric, with a whitish sclera Heart rate: 96 bpm with a 2/6 mesocardiac systolic murmur Hematological results Hemoglobin: 5.1 g/dl Mean corpuscular volume: 116 fl WBC: 2540/µL Neutrophil: 1230/µl Platelet count: 107000/mm3 Reticulocyte: 0.8% Serum indirect bilirubin: 4 mg/dl Lactate dehydrogenase: 5565 U/L SGOT: 150 U/L SGPT: 51 U/L Uric acid: 8.5 mg/dl Serum vitamin B12:…
