An 11-year-old male was presented in emergency room with recent onset of easy bruising, bleeding gums, and persistent epistaxis. Previously in excellent health. Mother stated he was "never sick before in his entire life." No history of recent viral infection, and no family history of bleeding disorders. Physical Exam Bleeding from the left nostril. Numerous petechiae and purpura; mostly on the extremities.
No organomegaly. Lab Results RBC4.52 x 1012/L,HGB 13.4 g/dL, HCT 37.2 %, MCV82.3 fL, MCH 29.6 pg, MCHC 35.9 g/dL RDW 12.1 WBC 5.3 x 109/L, N44%, L 39, M14, E1, B2 PLT <5 x 109/L MPV 10.9 fL What further investigation needs to be done? What is the most likely diagnosis? *This case is from Docplexus Editorial Team for educative purpose only .
