P336 A 20-month-old male with anemia and pneumonia

A 20-mo-o male with 2-day history of fever and cough. He was pale on exam with Hgb 3 mg/dL, RBC 3.12 X106/μL, MCV <50 fL/RBC. Fecal occult blood was positive. CXR showed RML infiltrate. He was hospitalized and given blood, antibiotics started. Stool microscopy showed charcot-leyden crystals. H. pylori stool antigen was positive, fecal calprotectin was borderline (95 μg/g), and stool alpha-1-antitrypsin was elevated (330 mg/dL), but negative for parasites, bacteria and viruses. Hemosiderin-laden alveolar macrophages were demonstrated in gastric aspirate.

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