Bone marrow biopsy findings in childhood anemia: prevalence of transient erythroblastopenia of childhood.

Abstract

Bone marrow examination is rarely required for the diagnosis of childhood anemia, and its diagnostic utility in this setting is unknown. Marrow specimens from 25 children aged 11 days to 12 years were reviewed to determine the cause of unexplained anemia. 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. 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.