Razi Journal of Medical Sciences
مجله علوم پزشکی رازی
RJMS
Medical Sciences
http://rjms.iums.ac.ir
39
journal39
2228-7043
2228-7051
en
jalali
1403
12
1
gregorian
2025
3
1
32
online
1
fulltext
fa
شیرخوار 3 ماهه با تب همراه با یافته های غیرطبیعی در اسمیر خون محیطی و رادیوگرافی استخوان ها
A 3-month-old infant with fever and abnormal findings in peripheral blood smear and bone radiography
آزمون تصویری
Test video
موردنگاري
case report
<br>
<span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span arial="" lang="AR-SA" style="font-family:">پسر 3 ماهه ای با تب و سرفه از چهار روز قبل به بخش اورژانس بیمارستان کودکان مراجعه کرد. در معاینه فیزیکی، بیمار تبدار بود (درجه حرارت 1/38 درجه سانتیگراد) دیسترس تنفسی نداشت و خس خس در ریه هر دو سمت سمع می شد.</span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span arial="" lang="AR-SA" style="font-family:">در معاینه فیزیکی برجستگی سفت در قسمت میانی کلاویکل هر دو سمت قابل لمس بود و لبه طحال پایین تر از لیه دنده ای لمس می گردید.</span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span arial="" lang="AR-SA" style="font-family:">در سابقه پزشکی ، شیرخوار حاصل زایمان ترم طبیعی با سیر تکاملی طبیعی بود و سابقه جراحی هرنی اینگوئینال هر دو سمت را در یکماهگی داشت . </span></span></span></span></span></span><br>
<br>
<span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span arial="" lang="AR-SA" style="font-family:">یافته های آزمایشگاهی در جدول زیر نمایش داده شده اند .</span></span></span></span></span></span>
<table align="right" class="Table" dir="rtl" style="margin-left:288px; border-collapse:collapse; border:none">
<tbody>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; height:5px; border-top:1px solid black; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Results</b></span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; height:5px; border-top:1px solid black; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Parameter</b></span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; height:5px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 26.5 <span lang="FA" dir="RTL" style="font-family:"Arial","sans-serif""></span></span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; height:5px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>WBC</b> <span arial="" dir="RTL" lang="FA" style="font-family:"> ) </span>x 10<sup>9</sup>/L )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 28</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">Segment ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 55</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">Lymphocyte ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 5</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">Monocyte ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 3</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">Band ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 3</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">Eosinophil ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 2</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">Myelocyte ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 4</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">NRBC ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 3.8</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>RBC </b> ( x10<sup>12</sup> /L )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 9.7</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Hb</b> ( g/ L)</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 29.4</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Hct </b> ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 78</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>MCV</b> ( fl )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 26</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>MCH </b> ( Pg )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 33</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>MCHC</b> (g/dl)</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 135</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Plt</b> (x 10<sup>9</sup>/L )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Retic Count </b>( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 7</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>ESR </b> ( mm/hr)</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; height:23px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 2</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; height:23px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>CRP</b> (mg/dl)</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; height:23px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 4</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; height:23px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>BUN </b>(mg/dl)</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; height:23px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 0/4</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; height:23px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Cr </b>(mg/dl)</span></span></span></td>
</tr>
</tbody>
</table>
<span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span lang="AR-SA" style="font-family:"Arial","sans-serif""></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span lang="AR-SA" style="font-family:"Arial","sans-serif""></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span arial="" lang="AR-SA" style="font-family:">یافته های اسمیر خون محیطی در تصویر 1 نشان داده شده است .</span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span arial="" lang="AR-SA" style="font-family:">با توجه به بیماری همه گیر</span> COVID-19<span arial="" lang="AR-SA" style="font-family:">، برای بیمار </span>PCR COVID-19 <span arial="" lang="AR-SA" style="font-family:">انجام شد که مثبت بود</span>.</span></span></span></span></span><br>
<span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span arial="" lang="AR-SA" style="font-family:">در سونوگرافی شکم اسپلنومگالی با دیامتر کرانیوکودال طحال 90 میلی متر یافت شد و در سایر ارگانها نکته پاتولوزیک رویت نگردید .</span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span arial="" lang="AR-SA" style="font-family:">با توجه به وجود آنمی و ترومبوسیتوپنی و همچنین یافته های اسمیر خون محیطی , بررسی رادیوگرافیک استخوان ها انجام شد ( تصویر 2 )</span> .</span></span></span></span></span><br>
<span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span arial="" lang="AR-SA" style="font-family:">با توجه به یافته های فوق تشخیص شما چیست؟</span></span></span></span></span></span><br>
<br>
<br>
<br>
<span style="font-size:11pt"><span style="line-height:107%"><span calibri="" style="font-family:">A 3-month-old boy with fever and cough <span style="font-size:12.0pt"><span style="line-height:107%"><span style="color:black">presented</span></span></span> to the emergency department of the children's hospital four days ago. In the physical examination, the patient was febrile (temperature 38.1 <span dir="RTL" lang="FA" style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times=""><span style="color:black">˚</span></span></span></span><span style="font-size:12.0pt"><span style="line-height:107%"><span style="color:black">c</span></span></span>), had no respiratory distress, and wheezing was heard in both lungs.</span></span></span><br>
<span style="font-size:11pt"><span style="line-height:107%"><span calibri="" style="font-family:">In the physical examination, firmness was palpable in the middle part of the clavicle on both sides, and the edge of the spleen was palpable below the rib cage.</span></span></span><br>
<span style="font-size:11pt"><span style="line-height:107%"><span calibri="" style="font-family:">In the medical history, the infant was born at normal term with normal development and had a history of inguinal hernia surgery on both sides at one month.</span></span></span><br>
<br>
<span style="font-size:11pt"><span style="line-height:107%"><span calibri="" style="font-family:">The laboratory findings are shown in the table below:</span></span></span><br>
<span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span lang="AR-SA" style="font-family:"Arial","sans-serif""></span></span></span></span></span></span>
<table align="right" class="Table" dir="rtl" style="margin-left:288px; border-collapse:collapse; border:none">
<tbody>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; height:5px; border-top:1px solid black; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Results</b></span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; height:5px; border-top:1px solid black; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Parameter</b></span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; height:5px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 26.5 <span lang="FA" dir="RTL" style="font-family:"Arial","sans-serif""></span></span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; height:5px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>WBC</b> <span arial="" dir="RTL" lang="FA" style="font-family:"> ) </span>x 10<sup>9</sup>/L )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 28</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">Segment ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 55</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">Lymphocyte ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 5</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">Monocyte ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 3</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">Band ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 3</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">Eosinophil ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 2</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">Myelocyte ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 4</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:">NRBC ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 3.8</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>RBC </b> ( x10<sup>12</sup> /L )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 9.7</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Hb</b> ( g/ L)</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 29.4</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Hct </b> ( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 78</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>MCV</b> ( fl )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 26</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>MCH </b> ( Pg )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 33</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>MCHC</b> (g/dl)</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 135</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Plt</b> (x 10<sup>9</sup>/L )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Retic Count </b>( % )</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 7</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>ESR </b> ( mm/hr)</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; height:23px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 2</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; height:23px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>CRP</b> (mg/dl)</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; height:23px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 4</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; height:23px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>BUN </b>(mg/dl)</span></span></span></td>
</tr>
<tr>
<td style="border-bottom:1px solid black; width:142px; padding:0cm 7px 0cm 7px; height:23px; border-top:none; border-right:1px solid black; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"> 0/4</span></span></span></td>
<td style="border-bottom:1px solid black; width:187px; padding:0cm 7px 0cm 7px; height:23px; border-top:none; border-right:none; border-left:1px solid black" valign="top"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b>Cr </b>(mg/dl)</span></span></span></td>
</tr>
</tbody>
</table>
<span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span lang="AR-SA" style="font-family:"Arial","sans-serif""></span></span></span></span></span></span><br>
<br>
<span style="font-size:11pt"><span style="line-height:107%"><span calibri="" style="font-family:">The findings of peripheral blood smear are shown in figure 1<span arial="" dir="RTL" lang="FA" style="font-family:">.</span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:107%"><span calibri="" style="font-family:">Due to the COVID-19 pandemic, the patient was tested for COVID-19 PCR, which was positive<span arial="" dir="RTL" lang="FA" style="font-family:">.</span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:107%"><span calibri="" style="font-family:">Abdominal ultrasound revealed splenomegaly with a craniocaudal spleen diameter of 90 mm, and no pathological findings were seen in other organs<span arial="" dir="RTL" lang="FA" style="font-family:">.</span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:107%"><span calibri="" style="font-family:">According to the existence of anemia and thrombocytopenia as well as peripheral blood smear findings, radiographic examination of the bones was performed (figure 2)</span></span></span><br>
<span style="font-size:11pt"><span style="line-height:107%"><span calibri="" style="font-family:">According to the above findings, what is your diagnosis<span arial="" dir="RTL" lang="FA" style="font-family:">?</span></span></span></span><br>
اسمیر خون محیطی , استئوپتروز , اسکلروز , رادیوگرافی
peripheral blood smear , osteopetrosis , Sclerosis ,radiography
0
0
http://rjms.iums.ac.ir/browse.php?a_code=A-10-6706-3&slc_lang=fa&sid=1
elham
zarei
الهام
زارعی
dr.elhamzarei@gmail.com
3900319475328460084725
3900319475328460084725
Yes
دانشگاه علوم پزشکی ایران
mehdi
vafadar
مهدی
وفادار
vafadar.m@iums.ac.ir
3900319475328460084726
3900319475328460084726
No
shirin
sayyahfar
شیرین
سیاح فر
sayyahfar.sh@yahoo.com
3900319475328460084727
3900319475328460084727
No
aziz
eghbali
عزیز
اقبالی
aziz-eghbali@yahoo.com
3900319475328460084728
3900319475328460084728
No