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Hi I Am Doing A Case Study And I Have
Question: Hi
I am doing a case study and I have some questions
The baby has hemolytic anemia (morphology) caused by HDFN, thrombocytopenia, anaphylaxis (referring immunoglobulin levels), and he needs blood transfusion from his sister.
are these right diagnosis??
XXXXXXX White was admitted to hospital at 11 months of age with an episode of bloody diarrhoea after which he appeared to be very pale. Initially breast fed, he had a previous history of severe reflux and fussy feeding behaviour which eased following the reduction of dairy products from his mother’s diet. Eczema was also noted from a few weeks of age on David’s arms and legs which was accompanied by small petechiae and became infected with Staphylcoccus aureus. He had also previously been treated for upper respiratory tract infections at 5, 7 and 9 months of age.
On further questioning David’s parents explained that XXXXXXX was a “fussy” baby and had seemed to have contracted more respiratory infections than his two older siblings, however they had thought this unremarkable as his older siblings attended day care.
On admission XXXXXXX was found to be afebrile, alert and active but distressed and tugging his ear. He had mild pallor pulse rate 92 per minute, was found to be small for his age, (under the 9th centile) and had an eczematous rash over the scalp and limbs. His ears were visualised by the attending physician and his left ear was found to be inflamed. Blood samples were taken for a number of tests and skin prick tests were undertaken. The results are displayed below along with normal ranges for the laboratory:
Results
Blood count
White blood cell count (x109/L): 7.4 (normal range 6 – 18)
Haemoglobin (g/dL): 6.0 (normal range 10 - 13.5 )
Total lymphocyte count (x109/L): 5.1 (normal range 3.0 - 13.5)
B cells: 11%
T cells: 85%
CD4/CD8 ratio: normal
Total granulocyte count (x109/L): 4.3 (normal range 1 - 9)
Platelet count (x109/L): 15 (normal range 150 – 350)
Immunoglobulins
IgG (mg/dL) 750 (normal range 235 – 1350)
IgA (mg/dL) 152 (normal range 0 – 83)
IgM (mg/dL) 30 (normal range >145)
IgE (unit/mL) 1550 (normal range 1.4-52)
Additional results
A Coombs test was positive
Specific antibody testing showed reduced levels of protective antibody to a number of antigens present in the routine vaccinations XXXXXXX had been administered.
HLA typing was carried out for XXXXXXX and his sisters, and one sister matched 8/8 HLA loci tested.
Skin prick testing demonstrated a wheel and flare response to milk protein.
I am doing a case study and I have some questions
The baby has hemolytic anemia (morphology) caused by HDFN, thrombocytopenia, anaphylaxis (referring immunoglobulin levels), and he needs blood transfusion from his sister.
are these right diagnosis??
XXXXXXX White was admitted to hospital at 11 months of age with an episode of bloody diarrhoea after which he appeared to be very pale. Initially breast fed, he had a previous history of severe reflux and fussy feeding behaviour which eased following the reduction of dairy products from his mother’s diet. Eczema was also noted from a few weeks of age on David’s arms and legs which was accompanied by small petechiae and became infected with Staphylcoccus aureus. He had also previously been treated for upper respiratory tract infections at 5, 7 and 9 months of age.
On further questioning David’s parents explained that XXXXXXX was a “fussy” baby and had seemed to have contracted more respiratory infections than his two older siblings, however they had thought this unremarkable as his older siblings attended day care.
On admission XXXXXXX was found to be afebrile, alert and active but distressed and tugging his ear. He had mild pallor pulse rate 92 per minute, was found to be small for his age, (under the 9th centile) and had an eczematous rash over the scalp and limbs. His ears were visualised by the attending physician and his left ear was found to be inflamed. Blood samples were taken for a number of tests and skin prick tests were undertaken. The results are displayed below along with normal ranges for the laboratory:
Results
Blood count
White blood cell count (x109/L): 7.4 (normal range 6 – 18)
Haemoglobin (g/dL): 6.0 (normal range 10 - 13.5 )
Total lymphocyte count (x109/L): 5.1 (normal range 3.0 - 13.5)
B cells: 11%
T cells: 85%
CD4/CD8 ratio: normal
Total granulocyte count (x109/L): 4.3 (normal range 1 - 9)
Platelet count (x109/L): 15 (normal range 150 – 350)
Immunoglobulins
IgG (mg/dL) 750 (normal range 235 – 1350)
IgA (mg/dL) 152 (normal range 0 – 83)
IgM (mg/dL) 30 (normal range >145)
IgE (unit/mL) 1550 (normal range 1.4-52)
Additional results
A Coombs test was positive
Specific antibody testing showed reduced levels of protective antibody to a number of antigens present in the routine vaccinations XXXXXXX had been administered.
HLA typing was carried out for XXXXXXX and his sisters, and one sister matched 8/8 HLA loci tested.
Skin prick testing demonstrated a wheel and flare response to milk protein.
Hi
I am doing a case study and I have some questions
The baby has hemolytic anemia (morphology) caused by HDFN, thrombocytopenia, anaphylaxis (referring immunoglobulin levels), and he needs blood transfusion from his sister.
are these right diagnosis??
XXXXXXX White was admitted to hospital at 11 months of age with an episode of bloody diarrhoea after which he appeared to be very pale. Initially breast fed, he had a previous history of severe reflux and fussy feeding behaviour which eased following the reduction of dairy products from his mother’s diet. Eczema was also noted from a few weeks of age on David’s arms and legs which was accompanied by small petechiae and became infected with Staphylcoccus aureus. He had also previously been treated for upper respiratory tract infections at 5, 7 and 9 months of age.
On further questioning David’s parents explained that XXXXXXX was a “fussy” baby and had seemed to have contracted more respiratory infections than his two older siblings, however they had thought this unremarkable as his older siblings attended day care.
On admission XXXXXXX was found to be afebrile, alert and active but distressed and tugging his ear. He had mild pallor pulse rate 92 per minute, was found to be small for his age, (under the 9th centile) and had an eczematous rash over the scalp and limbs. His ears were visualised by the attending physician and his left ear was found to be inflamed. Blood samples were taken for a number of tests and skin prick tests were undertaken. The results are displayed below along with normal ranges for the laboratory:
Results
Blood count
White blood cell count (x109/L): 7.4 (normal range 6 – 18)
Haemoglobin (g/dL): 6.0 (normal range 10 - 13.5 )
Total lymphocyte count (x109/L): 5.1 (normal range 3.0 - 13.5)
B cells: 11%
T cells: 85%
CD4/CD8 ratio: normal
Total granulocyte count (x109/L): 4.3 (normal range 1 - 9)
Platelet count (x109/L): 15 (normal range 150 – 350)
Immunoglobulins
IgG (mg/dL) 750 (normal range 235 – 1350)
IgA (mg/dL) 152 (normal range 0 – 83)
IgM (mg/dL) 30 (normal range >145)
IgE (unit/mL) 1550 (normal range 1.4-52)
Additional results
A Coombs test was positive
Specific antibody testing showed reduced levels of protective antibody to a number of antigens present in the routine vaccinations XXXXXXX had been administered.
HLA typing was carried out for XXXXXXX and his sisters, and one sister matched 8/8 HLA loci tested.
Skin prick testing demonstrated a wheel and flare response to milk protein.
I am doing a case study and I have some questions
The baby has hemolytic anemia (morphology) caused by HDFN, thrombocytopenia, anaphylaxis (referring immunoglobulin levels), and he needs blood transfusion from his sister.
are these right diagnosis??
XXXXXXX White was admitted to hospital at 11 months of age with an episode of bloody diarrhoea after which he appeared to be very pale. Initially breast fed, he had a previous history of severe reflux and fussy feeding behaviour which eased following the reduction of dairy products from his mother’s diet. Eczema was also noted from a few weeks of age on David’s arms and legs which was accompanied by small petechiae and became infected with Staphylcoccus aureus. He had also previously been treated for upper respiratory tract infections at 5, 7 and 9 months of age.
On further questioning David’s parents explained that XXXXXXX was a “fussy” baby and had seemed to have contracted more respiratory infections than his two older siblings, however they had thought this unremarkable as his older siblings attended day care.
On admission XXXXXXX was found to be afebrile, alert and active but distressed and tugging his ear. He had mild pallor pulse rate 92 per minute, was found to be small for his age, (under the 9th centile) and had an eczematous rash over the scalp and limbs. His ears were visualised by the attending physician and his left ear was found to be inflamed. Blood samples were taken for a number of tests and skin prick tests were undertaken. The results are displayed below along with normal ranges for the laboratory:
Results
Blood count
White blood cell count (x109/L): 7.4 (normal range 6 – 18)
Haemoglobin (g/dL): 6.0 (normal range 10 - 13.5 )
Total lymphocyte count (x109/L): 5.1 (normal range 3.0 - 13.5)
B cells: 11%
T cells: 85%
CD4/CD8 ratio: normal
Total granulocyte count (x109/L): 4.3 (normal range 1 - 9)
Platelet count (x109/L): 15 (normal range 150 – 350)
Immunoglobulins
IgG (mg/dL) 750 (normal range 235 – 1350)
IgA (mg/dL) 152 (normal range 0 – 83)
IgM (mg/dL) 30 (normal range >145)
IgE (unit/mL) 1550 (normal range 1.4-52)
Additional results
A Coombs test was positive
Specific antibody testing showed reduced levels of protective antibody to a number of antigens present in the routine vaccinations XXXXXXX had been administered.
HLA typing was carried out for XXXXXXX and his sisters, and one sister matched 8/8 HLA loci tested.
Skin prick testing demonstrated a wheel and flare response to milk protein.
Brief Answer:
Severe anemia possibly haemolytic anemia and thrombocytopenia.
Detailed Answer:
Hello dear, welcome to Ask a doctor's service.
I read your case and query and here is my advice.
I think that the baby is having a severe anemia possibly haemolytic anemia, (G6PD should be considered ) thrombocytopenia,
bloody diarrhea ( stool test is needed).
Also CRP should be done to check the possible viral infection.
Blood transfusion may be needed and also thrombocytes transfusion.
Hope I have answered the question.
Let me know if I can assist you further.
Severe anemia possibly haemolytic anemia and thrombocytopenia.
Detailed Answer:
Hello dear, welcome to Ask a doctor's service.
I read your case and query and here is my advice.
I think that the baby is having a severe anemia possibly haemolytic anemia, (G6PD should be considered ) thrombocytopenia,
bloody diarrhea ( stool test is needed).
Also CRP should be done to check the possible viral infection.
Blood transfusion may be needed and also thrombocytes transfusion.
Hope I have answered the question.
Let me know if I can assist you further.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Severe anemia possibly haemolytic anemia and thrombocytopenia.
Detailed Answer:
Hello dear, welcome to Ask a doctor's service.
I read your case and query and here is my advice.
I think that the baby is having a severe anemia possibly haemolytic anemia, (G6PD should be considered ) thrombocytopenia,
bloody diarrhea ( stool test is needed).
Also CRP should be done to check the possible viral infection.
Blood transfusion may be needed and also thrombocytes transfusion.
Hope I have answered the question.
Let me know if I can assist you further.
Severe anemia possibly haemolytic anemia and thrombocytopenia.
Detailed Answer:
Hello dear, welcome to Ask a doctor's service.
I read your case and query and here is my advice.
I think that the baby is having a severe anemia possibly haemolytic anemia, (G6PD should be considered ) thrombocytopenia,
bloody diarrhea ( stool test is needed).
Also CRP should be done to check the possible viral infection.
Blood transfusion may be needed and also thrombocytes transfusion.
Hope I have answered the question.
Let me know if I can assist you further.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hi thank you for your reply
I would like to ask is there any chance that he can be diagnosed Wiskott Aldrich syndrome or HUS?
I would like to ask is there any chance that he can be diagnosed Wiskott Aldrich syndrome or HUS?
Hi thank you for your reply
I would like to ask is there any chance that he can be diagnosed Wiskott Aldrich syndrome or HUS?
I would like to ask is there any chance that he can be diagnosed Wiskott Aldrich syndrome or HUS?
Brief Answer:
Seems more like Wiskott Aldrich.
Detailed Answer:
Hello dear and thank you for asking again.
This symptoms seem typical as Wiskott Aldrich syndrome and not much like HUS.
HUS may also have vomiting, abdominal pain, fever and changes in blood formula.
A thrombocytes test may be needed to check number and shape of thrombocytes and genetic test also.
Seems more like Wiskott Aldrich.
Detailed Answer:
Hello dear and thank you for asking again.
This symptoms seem typical as Wiskott Aldrich syndrome and not much like HUS.
HUS may also have vomiting, abdominal pain, fever and changes in blood formula.
A thrombocytes test may be needed to check number and shape of thrombocytes and genetic test also.
Above answer was peer-reviewed by :
Dr. Prasad
Brief Answer:
Seems more like Wiskott Aldrich.
Detailed Answer:
Hello dear and thank you for asking again.
This symptoms seem typical as Wiskott Aldrich syndrome and not much like HUS.
HUS may also have vomiting, abdominal pain, fever and changes in blood formula.
A thrombocytes test may be needed to check number and shape of thrombocytes and genetic test also.
Seems more like Wiskott Aldrich.
Detailed Answer:
Hello dear and thank you for asking again.
This symptoms seem typical as Wiskott Aldrich syndrome and not much like HUS.
HUS may also have vomiting, abdominal pain, fever and changes in blood formula.
A thrombocytes test may be needed to check number and shape of thrombocytes and genetic test also.
Above answer was peer-reviewed by :
Dr. Prasad
Thank you for your answer
I would like to if there is another possibility that the patient has another disease other than Wiskott Aldrich syndrome.
I understood that he has Wiskott Aldrich syndrome because of eczema, bloody diarrhea, petechiae, and thrombocytopenia. so HLA typing was done for blood transfusion. Moreover, he is allergic to milk.
However, I cannot correlate with immunoglobulin levels with Wiskott Aldrich syndrome.
I thought it supposed to be low IgM, IgG and normal IgA and IgE.
Also, I cannot relate reason of staphylococcus areus infection, upper respiratory tract infection and inflamed left ear with the patient.
Are there any possible disease that he has??
Thank you
I would like to if there is another possibility that the patient has another disease other than Wiskott Aldrich syndrome.
I understood that he has Wiskott Aldrich syndrome because of eczema, bloody diarrhea, petechiae, and thrombocytopenia. so HLA typing was done for blood transfusion. Moreover, he is allergic to milk.
However, I cannot correlate with immunoglobulin levels with Wiskott Aldrich syndrome.
I thought it supposed to be low IgM, IgG and normal IgA and IgE.
Also, I cannot relate reason of staphylococcus areus infection, upper respiratory tract infection and inflamed left ear with the patient.
Are there any possible disease that he has??
Thank you
Thank you for your answer
I would like to if there is another possibility that the patient has another disease other than Wiskott Aldrich syndrome.
I understood that he has Wiskott Aldrich syndrome because of eczema, bloody diarrhea, petechiae, and thrombocytopenia. so HLA typing was done for blood transfusion. Moreover, he is allergic to milk.
However, I cannot correlate with immunoglobulin levels with Wiskott Aldrich syndrome.
I thought it supposed to be low IgM, IgG and normal IgA and IgE.
Also, I cannot relate reason of staphylococcus areus infection, upper respiratory tract infection and inflamed left ear with the patient.
Are there any possible disease that he has??
Thank you
I would like to if there is another possibility that the patient has another disease other than Wiskott Aldrich syndrome.
I understood that he has Wiskott Aldrich syndrome because of eczema, bloody diarrhea, petechiae, and thrombocytopenia. so HLA typing was done for blood transfusion. Moreover, he is allergic to milk.
However, I cannot correlate with immunoglobulin levels with Wiskott Aldrich syndrome.
I thought it supposed to be low IgM, IgG and normal IgA and IgE.
Also, I cannot relate reason of staphylococcus areus infection, upper respiratory tract infection and inflamed left ear with the patient.
Are there any possible disease that he has??
Thank you
Brief Answer:
Hyper IgE syndrome also possible.
Detailed Answer:
Hello dear and thank you for asking again.
The Wiskott Aldrich syndrome people have elevated IgA and IgE but his IgE is very high.
Elevated IgE together with recurrent lung infections and staphylococcus aureus skin infection may be related to Hyper IgE syndrome ( another autoimmune disease)
Hyper IgE syndrome also possible.
Detailed Answer:
Hello dear and thank you for asking again.
The Wiskott Aldrich syndrome people have elevated IgA and IgE but his IgE is very high.
Elevated IgE together with recurrent lung infections and staphylococcus aureus skin infection may be related to Hyper IgE syndrome ( another autoimmune disease)
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
Hyper IgE syndrome also possible.
Detailed Answer:
Hello dear and thank you for asking again.
The Wiskott Aldrich syndrome people have elevated IgA and IgE but his IgE is very high.
Elevated IgE together with recurrent lung infections and staphylococcus aureus skin infection may be related to Hyper IgE syndrome ( another autoimmune disease)
Hyper IgE syndrome also possible.
Detailed Answer:
Hello dear and thank you for asking again.
The Wiskott Aldrich syndrome people have elevated IgA and IgE but his IgE is very high.
Elevated IgE together with recurrent lung infections and staphylococcus aureus skin infection may be related to Hyper IgE syndrome ( another autoimmune disease)
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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