Abstract
A 1½-year-old female child presented with swelling in thoracolumbar region and delayed
developmental milestones. The routine hemogram analysis on Sysmex XN 1000 showed flags
of white blood cell (WBC) abnormal scattergram and lymphocytosis. The peripheral smear
examination showed Alder–Reilly (AR) granules leading to a suspicion of underlying
Mucopolysaccharidosis (MPS). Further clinical workup, radiographic studies, chemical
test lead to the confirmatory diagnosis of MPS. A flag of abnormal WBC scattergram
and AR anomaly are the hematological findings that can be seen in a case of MPS.
Key words
Alder-Reilly anomaly - automated blood counters - mucopolysaccharidosis - Morquio
syndrome