Bone marrow biopsy findings in childhood anemia: prevalence of transient erythroblastopenia of childhood.
OBJECTIVE
Bone marrow examination is rarely required for the diagnosis of childhood anemia, and its diagnostic utility in this setting is unknown.


METHODS
Marrow specimens from 25 children aged 11 days to 12 years were reviewed to determine the cause of unexplained anemia.


RESULTS
These samples comprised only 2% of pediatric marrow examinations. Hematocrits ranged from 0.12 to 0.31 (mean 0.23). Marrow findings included erythroid hypoplasia (12 of 25, 48%) and hyperplasia (11 of 25, 44%), dyserythropoiesis (2 cases), ringed sideroblasts (2 cases), lymphocytosis (3 cases), and megaloblastic change (1 case). Final diagnoses were transient erythroblastopenia of childhood (15 cases, 60%); iron deficiency and sideroblastic anemia (2 cases each); and congenital dyserythropoietic anemia, anemia of chronic disease, hereditary spherocytosis, and intra-abdominal hemorrhage (1 case each). In two patients, a definitive diagnosis was never made.


CONCLUSIONS
Marrow examination contributed to a specific diagnosis in childhood anemia in 92% of cases; the most common diagnosis in this population was transient erythroblastopenia of childhood.
Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA.
D C
DC
Farhi
E L
EL
Luebbers
N S
NS
Rosenthal
D000740:Anemia / Q000175:diagnosis / Q000473:pathology*; D000742:Anemia, Dyserythropoietic, Congenital / Q000175:diagnosis; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis; D000756:Anemia, Sideroblastic / Q000175:diagnosis; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology*; D002648:Child; D004900:Erythroblasts / Q000473:pathology*; D006400:Hematocrit; D006801:Humans; D013103:Spherocytosis, Hereditary / Q000175:diagnosis