What's your opinion in this case?(Hematology)?

Question

A male patient, 6 years old complains of multiple spontaneous ecchymoses all over the body but more in the lower limbs with insidious onset and progressive course. They first appeared about 5 months ago with progressive pallor and anorexia. Faded without treatment (except antibiotics!!) then recurred again with the same distribution.
No fever, jaundice, petechial hemorrhage or bleeding per mucous membrane. Normal stool and urine color. Average anthropometric measurements. No hepatosplenomegaly or lymphadenopathy. No bone tenderness or joint swelling.
What's your provisional differential diagnosis?

Answer 1

if you expect any helpful answers you're going to have to lose the doctor terminology

Answer 2

No, keep the medical terminology. It will weed out the people who have no business answering the question in the first place.

Here is an excerpt from an article on bruising:

"The presence of bruises may be seen in patients with platelet or coagulation disorders. Unexplained bruising may be a warning sign of child abuse or serious medical problems, such as leukemia and meningoccocal infection. Anybody with unexplained bruising needs urgent examination by a doctor."

While I was reading your case history, I started thinking about leukemia, but I don't have the training to make any sort of definitive diagnoses. You should get a CBC and a manual differential for further evaluation.

Answer 3

Why antibiotics with no coagulation work up? ITP, medications, leukemia although this seems unlikely. A complete blood work u up is indicated CBC with differential, coagulation studies with platelet count and assay of coagulation factors for all the coagulation diseases. History of any bleeding disorder in families is important. I practiced hematology for 40 years.