Abdulrahman Abdullah Muhsen, Khalid Nawaf Abdurrahman.
Bone marrow examination in isolated childhood thrombocytopenia.
Pak Paed J Jan ;35(4):209-12.

Background: Immune thrombocytopenic purpura (ITP) is a common pediatric hematologic disorder. Bone marrow aspiration (BMA) is often performed in children with acute ITP to rule out leukemia, aplastic anemia or other hematologic diseases. However, whether BMA is needed in children with typical clinical and hematological features of acute ITP have been questioned. Objective: This study was performed to determine whether BMA is indicated in acute childhood ITP. Patients and Methods: This was prospective study. One hundred-twenty two patients with the provisional diagnosis of acute ITP were collected from August 2006 to June 2011 at Hevi pediatric teaching Hospital in Duhok/North of Iraq. Typical acute ITP was characterized by appearing well, no hepatosplenomegaly, no lymphadenopathy, normal hemoglobin, white blood cell count, neutrophil count and peripheral blood smear except thrombocytopenia. A platelet count of 50×109/L or lower was the cutoff level. Results: No diagnoses of leukemia or aplastic anemia were revealed in the 122 (100%) children with typical hematologic features of ITP. Conclusion: This study concludes that routine BMA is not needed for children with typical features of acute ITP.

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