Transient erythroblastopenia of childhood

My son is 28 months old. Two months ago he was diagnosed with severe anemia (hemoglobin: 5g/dL). He was hospitalized in a pediatric hospital, where he was given a blood transfusion. Bone marrow biopsy ruled out the existence of leukemia, and no congenital conditions that could cause the anemia were found. My son hadn't been taken any medicine prior to the onset of the anemia. Tests for virus infections (e.g. parvovirus) were negative. The final diagnosis was Transient Erythroblastopenia of Childhood. Have you heard about this? Is recurrence likely? Could this situation hide another illness? Is surveillance in the future necessary? Is he at a higher risk of developing leukemia?

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Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

The bone marrow is responsible for supplying the body with new blood cells as the old ones die. Since the life of the average red blood cell is about 120 days, the bone marrow has to put out enough red blood cells each day to replace those that die so that oxygen can continue to be supplied to the body. Transient Erythroblastopenia of Childhood is a condition in which the bone marrow temporarily shuts down its production of these red blood cells. Then, as the current red blood cells die off, there are no new ones to take their place. And since each of the red blood cells is in a different place in the lifespan, this loss of red blood cells causes gradual symptoms of becoming pale and increasingly tired.

By the time most children are brought to the doctor, this bone marrow shut down of red blood cells has been going on for several weeks. And most of the time, the bone marrow begins to produce more red blood cells before significant symptoms occur in the child. However, because of the nature of this condition, the shut down may last longer than it takes for all the present red blood cells to die. In these cases, children require blood transfusions until the bone marrow decides to start up again.

The cause of Transient Erythroblastopenia of Childhood is not well understood. The majority of children who develop Transient Erythroblastopenia of Childhood are between the ages of one and three. It is generally felt to be due to the bone marrow's reaction to or direct infection by a virus. The most typical (although controversial) one implicated in this condition is Parvovirus B19, the virus that causes Fifth Disease. However, the actual cause is most often never discovered. In either case, the good news is that children usually recover in one to two months and ordinarily do not need transfusions. In addition, once the child has fully recovered, there are no future complications that occur with this condition.

Transient Erythroblastopenia of Childhood is a relatively uncommon condition, so recurrence is extremely unlikely. It appears the doctors performed quite an extensive evaluation of your child. Presumably, they are quite certain of the diagnosis. This being the case, it is highly unlikely that this illness could be hiding another more serious one. Children usually fully recover within two months, so if any surveillance is done, it is usually limited to this time span. Finally, it does not appear Transient Erythroblastopenia of Childhood plays any role in future leukemia or any other blood disorder for that matter.

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