No abstract

A 5-year-old boy presented with neutropenia 9 weeks following the administration of rituximab for management of his steroid-dependent nephrotic syndrome. Extensive investigations failed to identify any underlying cause. In keeping with adult reports, rituximab was thought to be the likely cause for this ‘late-onset’ neutropenia (LOP). He was treated successfully with granulocyte-colony-stimulating factor. Patients treated with rituximab need to be carefully monitored for LOP.

QuestionsWhat is the differential diagnosis for infantile tibial bowing and what are the clinical clues that aid diagnosis?What is the most likely diagnosis in this case? How will you confirm the diagnosis?What is the significance for future surveillance and prognosis?What is the mechanism and complications of this bone abnormality?Answers can be found on page 2.