Age (m)/ time after treatment (m) | 3 | 4 | 5–7 | 8 | 9 | 12 | 14 | 15 | 15/+ 0.25 | 16/+ 1 | 17/+ 2 | 19/+ 4 | 23/+ 8 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Clinical | URI | diarrhea | PJP, PEM | – | Wide gap metabolic acidosis | Anemia | Hemolytic anemia, B. cereus sepsis | Anemia, fatigue | More active | – | – | – | Suspected ASD |
Liver/Spleen (cm)a | 2/1 | 3/1 | 5/2 | 0/0 | 0/0 | 0/0 | 2/0 | 7/0 | 5/0 | JP/0 | JP/0 | 0/0 | 0/0 |
Red cell transfusion | ✓ | ✓ | ✓ | X | X | ✓ | ✓ | ✓ | X | X | X | X | X |
Hydroxocobalamin (IM) | X | X | EN + PNb | X | X | X | X | 1 mg daily for a week then 1 mg twice a week | |||||
CBC | |||||||||||||
Hb (g/dL) | 3.7 | 5.7 | 8.2 | 10.3 | 14.4 | 8.7 | 3.5 | 9.4 | 9.9 | 10.5 | 12 | 12.3 | 13.7 |
MCV (fL) | 94 | 77 | 86 | 98.7 | 99.9 | 102 | 98.8 | 98.4 | 93 | 90.3 | 82.4 | 75.1 | 82.2 |
RDW (%) | ND | 16.3 | 17.4 | 28 | 15.2 | 16.2 | 26.6 | 31.3 | 22.2 | 19.3 | 15.7 | 13.8 | 13.6 |
WBC (109/L) | 4.67 | 2.3 | 20.6 | 7.5 | 14.0 | 6.8 | 14.6 | 7.2 | 8.67 | 9.94 | 9.01 | 12.32 | 9.82 |
N(%) | 14 | 65 | 35 | 14 | 60 | 12 | 29 | 27 | 30 | 20 | 13 | 33 | 16 |
Platelet (109/L) | 25 | 36 | 29 | 250 | 338 | 186 | 164 | 62 | 331 | 267 | 261 | 297 | 285 |
LDH (125–220 U/L) | 805 | 1606 | 610 | ND | ND | 1314 | 1786 | 673 | 365 | 362 | 275 | 297 | 288 |
Plasma homocysteine (5-15 μmol/L) | ND | ND | ND | ND | ND | ND | ND | 53.7 | 1.6 | 2.0 | 2.8 | 2.8 | 2.1 |
Development | – | – | Roll over, Chest up, Sit with support, no babbling | – | Sit without support | Feed NG, no sucking, no babbling, stand with aid | – | Stand with aided, no babbling, no meaning word | Feed orally, babbling, increased variety of sounds, stand unaided | Walk with aided | – | Walk unaided, no meaning word | Jump, scribble, few words, no imitate, one step command with gesture |