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Malignant infantile osteopetrosis in a 3-year-old Yemeni child: a case report
Saeed Thabet1,2, Mohammed Almajeedi2,3, Maged Mohammed2,3
1Hematology and Internal Medicine Department, Faculty of Medicine, Taiz University of Medical Sciences, Taiz, Yemen.
Insights
Infantile malignant osteopetrosis (IMOP) is a rare genetic bone disorder. Early diagnosis via clinical, imaging, and bone marrow tests is crucial, especially in limited-resource settings.
Area of Science:
- Pediatric Hematology
- Skeletal Dysplasias
- Genetic Bone Disorders
Background:
- Infantile malignant osteopetrosis (IMOP) is a rare autosomal recessive disorder.
- Characterized by osteoclast dysfunction leading to increased bone density.
- Clinical features manifest from birth or infancy.
Observation:
- A 3-year-old female presented with chronic anemia, hepatosplenomegaly, hypotonia, and visual impairment.
- Blood tests revealed pancytopenia and hypocalcemia.
- Radiology showed increased bone density and abnormal metaphyseal remodeling; bone marrow aspiration indicated hypocellularity.
Findings:
- Diagnosis of IMOP confirmed through integrated clinical, radiological, and bone marrow findings.
- The case highlights the diagnostic challenges and presentation of IMOP.
Implications:
- Emphasizes the importance of a comprehensive diagnostic approach for IMOP.
- Highlights the utility of clinical, radiological, and bone marrow aspiration in resource-limited settings.
- Underscores the rarity and severity of infantile malignant osteopetrosis.
Abstract:
Infantile malignant osteopetrosis (IMOP) is a rare bone resorptive disorder with an autosomal recessive inheritance pattern. It is characterized by increased bone density due to osteoclastic failure in differentiation or function. The clinical manifestations of IMOP start at birth or infancy with varied rings according to the type and degree of osteopetrosis. We presented a 3-year-old female patient referred to us due to chronic anaemia six months ago. The physical examination revealed hepatosplenomegaly, axial hypotonia, and visual impairment. Blood investigation revealed pancytopenia and hypocalcemia. Radiologic studies revealed a generalized increase in bone density, abnormal metaphyseal remodelling, and rain atrophy. The bone marrow aspiration (BMA) shows dry tap and hypocellularity of all cell lines. IMOP was diagnosed depending on clinical, radiologic, and BMA results. In conclusion, IMOP is relatively uncommon. Accurate diagnosis should be made through clinical, BMA, and radiologic investigations, especially in a resource-limited setting, as performed in our case.
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