To the Editor: In the March issue of the American Journal of Diseases of Children (107:267, 1964), Hagberg et al, described two infants with "malignant hyperlipemia" thought to represent a previously unknown inborn error of lipid metabolism. When this article appeared it happened that we were seeing an infant with strikingly similar clinical features—perhaps a third example of such a disorder.
A 4½-month-old white male infant was admitted March 3, 1964, after eight days of irregular fever. Prior to this illness he had been entirely well except for a very mild upper respiratory infection (URI) at age 2½ months. There is no family history of blood dyscrasia or metabolic disorder.
On admission the infant did not appear ill (temperature, 105 F [40.6 C], pulse, 120; respiration, 24). Conspicuous hepatosplenomegaly was the only abnormal physical finding. Admission laboratory routines promptly revealed a disturbing pancytopenia (hemoglobin, 6.9 gm%; WBC 3,700/cu mm with