Transient erythroblastopenia of childhood associated with transient neurologic deficit: report of a case and review of the literature

Diagnosing Transient Erythroblastopenia of Childhood: A Review for Pediatricians

Transient erythroblastopenia of childhood is a rare, benign, self-limited condition seen in infants and young children. Laboratory studies will show moderate or severe normochromic normocytic anemia accompanied by absent or low reticulocytes, neutropenia, and mild thrombocytosis or thrombocytopenia. The etiology is unclear, but it has been associated with clinical or laboratory evidence of a recent viral syndrome. Initial diagnostic studies should be aimed at identifying potential causes of anemia, but a confirmed diagnosis is usually obtained once the hemoglobin level has normalized spontaneously. Differentiation from Diamond-Blackfan anemia is critical, especially in infants. Once the diagnosis is established, treatment is supportive, but red blood cell transfusion is indicated in severe cases. High clinical suspicion is imperative to avoid needless diagnostic and therapeutic measures. [Pediatr Ann. 2024;53(1):e34-e36.].

Transient Erythroblastopenia of Childhood: A Review for the Pediatric Emergency Medicine Physician

Transient erythroblastopenia of childhood is a form of pure red cell aplasia that is self-limited and occurs in children 4 years old and younger. It is characterized by an absence or a significantly reduced quantity of erythroblasts in the bone marrow without underlying congenital red blood cell abnormalities. Transient erythroblastopenia of childhood should be considered in previously healthy children who present with normocytic anemia and lack of reticulocytosis without evidence of blood loss, hemolysis, or other causes of bone marrow suppression. Evaluation should be targeted at ruling out other causes of anemia. Management is mainly supportive, although some children may require blood transfusions for symptomatic anemia. Most patients demonstrate a return of hematopoiesis within two weeks of diagnosis and normalization of blood counts within two months.

Transient erythroblastopenia of childhood is an underdiagnosed and self-limiting disease

AIM

Transient erythroblastopenia of childhood (TEC) is an uncommon, benign normocytic anaemia of unknown cause, characterised by reduced or absent mature erythroid precursors in otherwise normocellular bone marrow and a complete spontaneous recovery. We present epidemiological data on paediatric TEC cases in a single centre over 30 years and compare them with published data.

METHODS

In this retrospective study, epidemiological data on children diagnosed with TEC between 1978 and 2008 were collected and compared with published data.

RESULTS

A total of 36 children (median age 19 months, 56% male children) were diagnosed. At presentation, median haemoglobin was 44 g/L with absolute reticulocyte count 0 × 10(9) /L; seventeen (47%) patients were neutropenic and 23 (64%) had platelet counts of more than 400 × 10(9) /L. The majority (78%) presented from 1983 to 1997, and 78% of articles reviewing 10 or more TEC patients were published between 1983 and 1992.

CONCLUSION

Transient erythroblastopenia of childhood is now diagnosed less frequently in our institution than in the last two decades. Although the aetiology remains largely unknown, it is possible that changes in causative environmental factors contribute to making TEC a rare disease. Clinicians need to be aware of TEC in order to prevent unnecessary diagnostic and therapeutic measurements.

Ectopic atrial tachycardia in an infant with transient erythroblastopenia of childhood

Transient erythroblastopenia of childhood is a self-limited anemia occurring in previously healthy children, secondary to temporary cessation of erythrocyte production. Although the precise etiology is unclear, most cases are associated with a viral illness. The anemia may be severe, with associated pallor, tachypnea, and tachycardia; treatment is supportive. We present an unusual case of a child with viral-induced transient erythroblastopenia of childhood and associated ectopic atrial tachycardia, requiring therapy with antiarrhythmics.

Ticks and tick paralysis: imaging findings on cranial MR

Tick paralysis is an acute, progressive, and potentially fatal muscle paralysis secondary to a toxin secreted by a pregnant tick during a bite. Although tick bites can occur anywhere on the body, ticks are frequently overlooked on the scalp because of overlying hair. Children with acute neurologic symptoms frequently undergo MR scanning that may incidentally reveal the offending tick. Timely identification and removal of the tick leads to rapid recovery from tick paralysis. We report the MRI findings at 1.5 T of tick paralysis with an attached tick.