Muneeza Natiq, Nisar Ahmad, Junaid Rashid.
Frequency and clinico-hematological features of pure red cell aplasia in children.
Pak J Med Health Sci Jan ;4(2):82-8.

Objective: To study the frequency and clinical & hematological pattern of pure red cell aplasia in children. Study Design: Prospective Descriptive study. Place and Duration of Study: It was carried out in the department of Hematology and Transfusion medicine of the Children’s Hospital and the Institute of Child Health, Lahore from June 2004 to December 2008. Patients and Methods: This study included children up to 5 years of age who presented with pallor. Detailed history and examination was entered on a pre-designed performa, and relevant investigations were done. Children with normochromic normocytic anemia, low reticulocyte count and absent erythroid activity in the marrow were labeled as pure red cell aplasia. Other types of anemia were diagnosed according to their respective diagnostic criteria. Data was analyzed using SPSS version 10 on computer. Results: Out of 1800 children of anemia, deficiency anemia was diagnosed in 1640 children (91.1%), hemolytic anemia in 120 children (6.67%), pure red cell aplasia in 30 children (1.6%), congenital dyserythropoeitic anemia in 08 children (0.4%) and sideroblastic anemia in 2 children (0.1%). Out of 30 children of pure red cell aplasia, Diamond Blackfan anemia was diagnosed in 23 children (80%) and transient erythroblastopenia of childhood in 7 children (20%). The mean age of DBA (Diamond Blackfan Anemia) was 4.12+3.21 months and male:female 1:1.5, while in TEC (Transient Erythroblastopenia of Childhood) it was 3.80+ 2.01 years, and the male:female was 1:1.3. Fever and history of preceding viral infection was present in 100% cases of TEC, while in DBA fever was present in 60% cases without history of preceding viral infection. Reticulocyte count in DBA and TEC was <0.5% and <0.3% respectively. Absent and reduced erythropoeisis in bone marrow examination was found in both the entities. Conclusion: Pure red cell aplasia constituted about 1.6% of all anemia in children less than 5 years of age.

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