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Pale and distended

24 year old youngest born to consanguineous parents (3rd degree) presented with Abdominal distension and pain, Anemia hepatosplenomegaly, from April 2018 pain in back joints and whole body, epistaxis 4-5 times in the childhood and off and on now for past 1 year, bleeding from gums recurrent for I month, breathlessness on walking


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