Anaemia, vitamin E deficiency and failure to thrive in an infant.

An 8-week-old boy presented with failure to thrive from birth. He had been fed with breast and formula milk. He had an anaemia of 6.6 g/dl with polychromasia, nucleated red blood cells and immature myeloid cells in the peripheral blood. He showed evidence of haemolysis with a reticulocyte count of 120 x 10(9)/l, a raised unconjugated bilirubin and had low plasma protein levels. Investigation revealed a low vitamin E level and a diagnosis of cystic fibrosis.