Investigations
| Values | Normal Limits | |
|---|---|---|
| WBC | 3.1 (diff 1.6 neutrophils and 2.8) | (4-12×109/l) |
| HB | 4.0999999999999996 | (12.1-15.2g/l) |
| MCV | 78.8 | (80-96 fl) |
| Platelets | 15 | (140-45×109/l) |
| Reticulocyte count | 5.6000000000000001E-2 | (0.8-4% RBC) |
| Smear: | ||
| Normochormic, normocytic anaemia with spherocytes | ||
| Red cell fragments | ||
| Left shift in neutrophils | ||
| LDH | 953 | (70-250 u/l) |
| Haptoglobin (free serum) | 0.45 | (27-139 mg/dl) |
| Coombs direct | Positive | |
| INR | 0.9 | (1.0-1.3) |
| PTT | 30 | (23-31) |
| WR | Negative | |
| TPHA | Negative | |
| Toxoplasmosis | Negative | |
| Rubella | Negative | |
| Parvovirus B19 | Negative | |
| Malaria | Negative | |
| Herpes | Negative | |
| CMV | Negative | |
| Total bilirubin: | 22 | (3-17 umol/l) |
| Uncongugated bilirubin: | 15 | (0.0-0.3 mg/dl) |
| ANA | Positive | |
| Anti Ro: | 104 | |
| Anti La: | 156 | |
| ACLA: IgG | 18 | |
| ACLA IgM | 12 | |
| B2 glycoprotein | Normal |
Mothers Results
WR: negative
ANA: Positive, titre 1280 speckled pattern
dsDNA: negative
Anti Ro: 96
Anti La: 144
Abdominal ultrasound
Features of hepatomegaly
Splenomegaly with multiple microabscesses
Very thickened bladder with dilated post urethra
Bone marrow trephine
Reactive changes in RBC and megakaryopoeitic precursor
Focus granulation tissue secondary to previous haemorrhage
No granulomatous infiltration
No neoplastic infiltrate
CT Brain
Day 16 post admission, infant developed a seizure.
CT scan shows multiple parenchymal bleeds and oedema
29 Days later CT scan shows decreased bleeding and oedema.
