Erythroblastopenia, Transient

Key Features

• Age: 6 months to 4 years

• Normocytic anemia with reticulocytopenia

• Absence of hepatosplenomegaly or lymphadenopathy

• Erythroid precursors initially absent from bone marrow

Clinical Findings

• Pallor is the most common sign

• Hepatosplenomegaly and lymphadenopathy are absent

Diagnosis

• Anemia is normocytic

• Peripheral blood smear shows no evidence of hemolysis

• Platelet count is normal or elevated

• Neutrophil count is normal or, in some cases, decreased

• Early in the course, no reticulocytes are identified

• The Coombs test is negative, and there is no evidence of chronic kidney disease, hypothyroidism, or other systemic disorder

• Bone marrow examination shows severe erythroid hypoplasia initially; subsequently, erythroid hyperplasia develops along with reticulocytosis, and the anemia resolves

Treatment

• Some children require red cell transfusions if cardiovascular compromise is present

• Resolution of the anemia is heralded by an increase in the reticulocyte count, which generally occurs within 4–8 weeks of diagnosis

• Corticosteroids not needed because of short course