5month old MALNOURISHED baby with spontaneous bleed,with no splenomegaly & mild hepatomegaly.Lab investigations showing anemia,neutropenia & thrombocytopenia.A hypercellular marrow with megaloblastic changes probably clinches the diagnosis.The infant probably also has Iron deficiency anemia accounting for microcytes in peripheral smear.Intramedullary destruction of precursor cells accounts for ineffective erythropoiesis & mild hyperbilirubinemia in this case.
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