Imaging Diagnosis of Neonatal Anemia: Report of Two Unusual Etiologies
A 3-month-old male infant was also brought with features of pallor, recurrent respiratory infections, and abdominal distension since birth. Records of previous hospitalization revealed persistent anemia (hemoglobin (Hb) 8.1 g/dl) and thrombocytopenia (platelet count-23,000 cells/mm3). Skeletal survey was requisitioned for this infant at our hospital to exclude congenital infections. Radiographs in this patient revealed diffusely increased bone density with loss of medullary cavity in the long bones [Figures and ]. A ‘bone within bone’ appearance was also noted in the ends of long bones []. Radiograph of dorsolumbar spine showed increased density of the vertebral body with central linear lucency giving the appearance of ‘sandwich vertebra’ []. Radiograph of the skull revealed marked sclerosis of the skull base []. Computed tomography (CT) of the brain done with adequate body lead shielding and using minimal dose, did not reveal any hydrocephalus or cranial nerve compression []. The radiological features were characteristic for OP. Attempted bone marrow aspiration revealed a dry tap. Bone biopsy revealed disorganized bony trabaculae with obliteration of marrow spaces, which confirmed the diagnosis of OP [].