Apy Liu, JCC So, CCK Lam, SY Ha, GCF Chan, BHY Chung

A 5-year-old boy was noted to be pale-looking. He had otherwise good past health and was thriving well along the 10th centile. Physical examination revealed significant pallor without jaundice. There was absence of lymphadenopathy, bruises or petechiae in general examination. Abdominal examination showed hepatosplenomegaly, with liver palpable 2 cm below the costal margin and the spleen enlarged to 6 cm below costal margin. There was a systolic flow murmur.

Complete blood count revealed haemoglobin level of 5.4 g/dL (MCV 79fl). The total white cell count was 5.27 x 10⁹/L and platelet count 76 x 10⁹/L. Chest X-ray and peripheral blood smear of the patient was shown.

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