2. The 1 ½ year old girl brought to OPD with C/O
increasing pallor and bleeding gums from the past 2
days. Mother gives H/O fever for the last 1 ½ month for
which she has been treated symptomatically with no
relief.
O/E she is markedly pale, febrile with temp 101FO
and pulse of 140/min there is some ooze of blood from
the gums and few purpuric spots on trunk. Spleen is
palpable 6cm below costal margin and liver is enlarged
2cm below costal margin. Her investigations show TLC
2.9x109/L, platelet 40000/mm3 and Hb of 5gm/dl.
Her serum ferritin levels are 3000 ng/dl and she is
having Tevel of 300 mg/dl.
3. a) What is the most probable diagnosis ?
b) Name 2 other investigations to confirm diagnosis ?
c) Enlist diagnostic criteria ?
d) Name drugs used for treatment ?
4. a) MAS (secondary hemophagocytic sundrome or
hemophagocytic lymphohistiocytosis)
