Blood teaser

9 month infant admitted for skin abscess. What is the hematologic diagnosis?  Name the hematologic index that would help further test for this diagnosis.

WBC  (K/CMM)	7.8
RBC  (M/CMM)	4.66
Hb  (g/dL)	9.7
HcT (%)	29.6
MCV (fL)	63.5
MCH (pg)	20.8
MCHC (g/dL)	32.7
RDW (%)	17.0
PLT (K/CMM)	211
MPV (fL)	8.3

Hint:

The six discrimination indices are:

• Mentzer Index  (MI): MCV / RBC
• Green & King Index (G&K): MCV  × RDW / (Hb × 100)
• RDW Index (RDWI): MCV × RDW / RBC
• England & Fraser Index  (E&F): MCV − RBC-(5 × Hb) − k [k = 6.4]
• RDW
• RBC count

 

 

Based on one of the above index what is next test to order?

 

1. Hb A2 (Hemoglobin electrophoresis)

2. serum ferritin

3. vitamin B12

4. bone marrow aspiration

5. serum lead

Nagging neck pain

10 yr old boy  with neck pain and high fever. He had two weeks of upper respiratory tract infection.

What is the diagnosis? And identify the markers.