This 23-year-old black female delivered a stillborn infant by Caesarean sectionwent to her doctor because of chronic fatigue, bone pain, following which she experienced excessive uterine bleeding including the passage of blood clotsand easy bruising and frequent nose bleeds. Further study revealed an enlarged spleen Physical exam demonstrated hepatomegaly and splenomegaly and lab results demonstrated anemia and thrombocytopenia (platelet count 58,000). A splenectomy was performed with an uneventful postoperative course other than persistent pain in her right leg (the right hip had been fractured 2 years earlier). Subsequently she developed aseptic necrosis of the left femoral head requiring Biopsy and further workup led to a prosthetic replacement. Microscopic evaluation of the bone removed at the time diagnosis of surgery revealed Gaucher cells in the marrow spacedisease.

== Autopsy Findings ==The surgical specimen Despite appropriate therapy the anemia and thrombocytopenia persisted as well as the severe splenomegaly. A splenectomy was a 935 gram spleenperformed. Its The surface of the spleen was pale with an area of bluish discolorationand roughly granular. The cut surface revealed the same pale appearance.