MYELOFIBROSIS IN SEVERE COMBINED IMMUNODEFICIENCY DUE TO VITAMIN-D DEFICIENCY RICKETS

An infant with severe combined immunodeficiency is described in whom a refractory anemia and thrombocytopenia developed after the age of 6 m onths, associated with poor growth and frequent episodes of upper resp iratory tract infections and diarrhea. He required frequent blood and platelet transfusions. Bone marrow biopsy provided evidence that the a nemia and thrombocytopenia were the results of myelofibrosis which was secondary to vitamin D deficiency. Therapy with 1,25-dihydroxycholeca lciferol resulted in resolution of the hematologic and skeletal abnorm alities, but he remained susceptible to recurrent serious infections a nd died at the age of 13 months.