Infantile malignant osteopetrosis with interesting bone marr
The present case has been reported in the Allied Journal of Clinical Pathology Research.

A 6 months old female infant presented reported with fever since 7 days. On clinical examination she was found to have pallor and hepatosplenomegaly. Her initial investigations revealed anemia (Hb-7.0 g/dl) and thrombocytopenia (Platelets: 38,000 /cumm).

Peripheral smear findings revealed normocytic normochromic RBCs with anisopoikilocytosis, tear drop cells, nucleated red cells (25 nRBCs/100 WBCs) and leucoerythroblastic blood picture with peripheral smear showing shift to left upto blasts. Biochemistry workup revealed very high Lactate dehydrogenase (LDH) 2534 U/L (170-450 U/L), elevated Aspartate aminotransferase (AST) and Alanine aminotransferases (ALT) level.

Based on peripheral smear finding, bone marrow aspiration and biopsy was advised and was obtained from posterior superior iliac spine. Bone marrow aspiration was dry tap. Bone marrow trephine biopsy revealed disorganized bony trabeculae, decreased bone marrow spaces with markedly suppressed trilineage hematopoiesis, focal areas of fibrosis and areas of new woven bone formation.

Plain radiograph of left Forearm and wrist revealed generalized increase in bone density and bone within bone appearance which is characteristic of infantile malignant osteopetrosis.

After the diagnosis was made, supportive treatment was given as blood transfusion for correction of anaemia, broad spectrum antibiotics to counteract infection along with calcitriol which helps to stimulate dormant osteoclast under the Paediatrics department of our center. Bone marrow transplantation was advised to the patient, but parents were non- affording. However, the condition of patient deteriorated and patient died eventually after 3 months.

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