Sujit Ranjane

A 5 years old boy came with not gaining height. Mother gives similar history of slow growth of her height. On examination, weight is 11kg (for expected 18 kg for his age), height is 90cms with upper segment- lower segment ratio of 1. On investigation, his CBC shows dimorphic anemia with high eosinophilic count. X-ray wrist shows bone age of 3 years. How to investigate further?  

A 3 years year old boy presented with increased pigmentation of lips, knuckles and toes since 6 months of age. The child is on full vegetarian diet. He has very poor intake of vegetables and fruits and also is a very fussy eater. Investigations showed: Hemoglobin = 10.0 gm/dl (Peripheral smear shows dimorphic anemia and hypochromia present), WBC count = 4,000/cu mm, platelet count = 1,40,000/cu mm  

What is the cause of his hyperpigmentation? How to confirm the diagnosis? How to treat this problem? How to rectify the problem?

Ira Shah
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