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Dr. Andrew Rynne

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Infant with elevated LFTs, enlarged spleen and petechial rashes. What is the required treatment?

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Dr. Hema Yadav

Pediatrician, Infectious Diseases

Practicing since :2005

Answered : 1528 Questions

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Posted on Mon, 28 Jan 2013 in Child Health
Question: I have a 18 month old son who has had elevated LFT's for the past 9 months as well as frequent hospitalisations for petechiae rashes. All other blood work seems normal. It seems he gets a small infection (bronchiolitis, hand foot mouth etc) and then breaks out in this rash. Along with the following his spleen is enlarged.

Any idea as to why these rashes keep recurring?
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Answered by Dr. Hema Yadav 2 hours later
Hello,
Thanks for posting your query.
I assume that your child is suffering from recurrent petechiael rash for which the cause hasn't been diagnosed yet .
Recurrent petechiael rash with elevated LFTs and enlarged spleen could most probably be either due to a platelet disorder or viral infection or a drug reaction .
Rarely Other bleeding disorders or immunological disorders or metabolic disorders can also present like this.
If your child has been investigated thoroughly by his doctors to rule out any platelet or coagulation disorder ( by Normal complete blood count , coagulation profile etc ) then it's most likely to be due to a viral infection ( enterovirus ) and should resolve on its own or with supportive therapy.
However considering that it's been recurring since 9 months and there is derangement of liver and spleen it's advisable to get him further evaluated by a pediatric hemat-oncologist or an infectious disease specialist ( if hematological investigations are normal ).
In cases of recurrent viral infections the child should be screened for any immunological deficiency by the specialists.
Please do not worry as many of such conditions are treatable nowadays and hence a prompt evaluation is advisable.
Hope I have answered your query.
I'll be available for any follow up queries.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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