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 4-yo boy with leg pain  

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4 yo boy has severe pain in both of his legs. On PE, his temp is 99.8, BP 108/68, PR 96, RR 17. He has marked pallor on his lips andn palpebral conjunctiva. Numerous purpura and petechiae are noted on his skin. His spleen is palpable 3 cm below his left costal margin. lab revelas WBC 1600, Hb 6.1, plt 36,000.
Which of the following diagnoses is most consistent with these findings?
a. acute lymphcytic leukemia
b. aplastic anemia
c. Henoch-Schonlein purpura
d. Immune thrombocytopenic purpura
e. thrombotic thrombocytopenic purpura


a. acute lymphcytic leukemia


a. acute lymphcytic leukemia


Pls can U explain why it's not immune thrombocytopenic purpura



ITP is usually preceded by URI and nonpalpable spleen. Anemia and lymphocytosis can be seen, but most of the time, only platelet is decreased.

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