A 13 month-old boy was referred from a community hospital with problems of  anemia and
hepatospelnomegaly suspected of hematologic malignancy. He was the second child of the
consanguineous parents. He was born at a community hospital by normal, uneventful delivery.
His birth weight was 3,300 grams.

     He had been well, properly developed and fully immunized until 4 months of age. At that time
he became anemic and was admitted to a hospital with a diagnosis of "blood disease".
After that, he was given a total of five PRC transfusions every other months before the referral.
His development became slow and regressed. At 13 months of age, he could turn over but was
not able to sit and could speak a few words.

     The first child of the family died four years ago at 18 months of age. He had the same
symptom of anemia which required multiple blood transfusions.