PEDIATRICS Vol. 47 No. 6 June 1971, pp. 1089-1090
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Letterer Siwe's Disease?

Rafael Lopez M.D.1 and David C. Mauger 2

1 Department of Pediatrics, New York Medical College, Fifth Avenue at One Hundred and Sixth Street, New York, New York 10029
2 Auckland Hospital, Park Road, Auckland, 3, New Zealand

I have read with interest the article of Dr. D. C. Mauger on Letterer-Siwe's disease complicated with intravascular coagulation (Pediatrics, 47: 435, 1971). I think that the possibility of intravascular coagulation has not been proven conclusively in the absence of measurement of some key factors, especially with the degree of hepatosplenomegaly this patient presented. Though it cannot be said of every situation, in the absence of decrease factor VIII and increase fibrin split products, the diagnosis of disseminated intravascular coagulation cannot be made with certainty.