title: Osteopetrosis in two siblings: two case reports.
abstract: BACKGROUND
  Osteopetrosis is a rare inherited metabolic bone disorder characterized by extensive sclerosis of skeletons, visual and hearing impairment, hepatosplenomegaly and anemia. It has two major clinical forms: the autosomal dominant adult (benign) form is associated with milder symptoms often appearing in later childhood and adulthood whereas the autosomal recessive infantile (malignant) form has severe presentations appearing in very early childhood, if untreated, is typically fatal during infancy or early childhood. A rare autosomal recessive (intermediate) form is present during childhood with some signs and symptoms of malignant osteopetrosis. Diagnosis is mainly based on clinical and typical generalized increase in bone density.
  
  
  METHODS
  The two siblings of Indo-Aryan ethnicity, aged five and 8 years, were admitted with irregular low grade fever and gradually increasing abdominal mass for last 3 years. They also had history of hearing loss. On examination, the patients were found pale with poor nutritional status, short stature, frontal bossing and splenomegaly. We made a clinical diagnosis of hemolytic anemia and investigated accordingly. Peripheral Blood Smear was suggestive of leucoerythroblastic picture in both the siblings. We extended our investigations and radiological survey revealed generalized increase in bone density which was consistent with osteopetrosis.
  
  
  CONCLUSIONS
  Osteopetrosis is a rare disease transmitted by autosomal dominant or recessive inheritance having variable penetrance. We report here milder form of disease in the two siblings having typical clinical features in the form of anemia, hepatosplenomegaly and hearing loss. Diagnosis was confirmed by typical generalized increase in bone density in both the patients.
authors.affiliation: Department of Pediatrics and Adolescent Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. doctorsat_99@hotmail.com.
authors.forename: Satish
authors.initials: S
authors.lastname: Yadav
authors.affiliation: Department of Pediatrics and Adolescent Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. ascol04@yahoo.com.
authors.forename: Shiv
authors.initials: S
authors.lastname: Chalise
authors.affiliation: Department of Pediatrics and Adolescent Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. shiprachaudhary@hotmail.com.
authors.forename: Shipra
authors.initials: S
authors.lastname: Chaudhary
authors.affiliation: Department of Pediatrics and Adolescent Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. gaurisshah@yahoo.com.
authors.forename: Gauri Shankar
authors.initials: GS
authors.lastname: Shah
authors.affiliation: Department of Radiology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. mukeshgupta148@yahoo.com.
authors.forename: Mukesh Kumar
authors.initials: MK
authors.lastname: Gupta
authors.affiliation: Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. opmpedia@yahoo.co.uk.
authors.forename: Om Prakash
authors.initials: OP
authors.lastname: Mishra
mesh_terms: D015519:Bone Density; D006801:Humans; D010022:Osteopetrosis / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D012598:Sclerosis; D035781:Siblings; D012886:Skull / Q000000981:diagnostic imaging / Q000473:pathology; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology
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