Case 20-2003: A Nine-Year-Old Girl with Hepatosplenomegaly and Pain in the Thigh

Presentation of CaseA nine-year-old girl was admitted to the hospital because of hepatosplenomegaly and pain in the thigh.The patient had been well until three years earlier, when she began to have frequent episodes of epistaxis. Two years before admission, mild abdominal distention developed. Periodic examinations by her physician were reported to have revealed no abnormalities. Two months before admission, the abdominal distention worsened but was not accompanied by abdominal pain. Physical examination revealed hepatosplenomegaly. An abdominal ultrasonographic study confirmed the presence of hepatosplenomegaly, without evidence of portal-vein thrombosis (Figure 1). The results of liver-function tests were normal or . . .