Amna Imtiaz, Lubna Naseem and Sundas Ali
Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad
Juvenile Myelomonocytic Leukemia (JMML), which comes under the WHO category of Myelodysplastic/ Myeloproliferative Neoplasms, is a rare aggressive hematological malignancy of early childhood caused by excessive proliferation of cells of monocytic and granulocytic lineages. The peripheral blood shows leukocytosis, thrombocytopenia and anemia. The majority of patients present with infection. Hematopoietic Stem Cell Transplantation (HSCT) is the best treatment option available. Here we present a case of a one year old female child who presented with complaints of fever, cough and progressive pallor for the last six months and abdominal distention associated with vomiting, diarrhea and sub-conjunctival hemorrhages for past 2 months. The fever did not respond to medication. She developed sepsis and intracranial bleed and expired on the 10th day of hospitalization.