TRANSIENT ERYTHROBLASTOPENIA OF CHILDHOOD - PROSPECTIVE-STUDY OF 50 PATIENTS

Purpose: To prospectively evaluate 50 patients with transient erythrob lastopenia of childhood (TEC) at a single institution in order to comp are those patients presenting with reticulocytopenia (group I) with th ose presenting in the recovery phase with reticulocytosis (group II); to further describe the clinical course of this common pediatric hemat ological disorder in a large number of patients, particularly the effe ct on the neutrophils; and to review the available literature regardin g this disorder. Patients and Methods: Fifty patients presenting to th e Children's Hospital from September 1983 to September 1991 were prosp ectively evaluated. Those patients with a reticulocytosis and in recov ery at the time of diagnosis were included and compared with those wit h reticulocytopenia. All patients were followed through complete recov ery. Results: Thirty-six patients were reticulocytopenic (group I) and 14 had a reticulocytosis (group II). There was a high incidence of ne utropenia (64%) in both groups and the resolution of this neutropenia was variable in relation to the resolution of the anemia, with 44% hav ing the lowest ANC before, 9% simultaneous with, and 47% after the pea k reticulocyte count. Conclusions: Our experience with a large group o f patients with TEC suggests that neutropenia is an integraI part of t his disorder, and its recovery has no relation to the recovery of the anemia. A significant number of patients are described in the recovery phase for the first time, and this clarifies this group of patients i n order to aid in their diagnosis, particularly in the differentiation from a hemolytic process. Some previously described associations of T EC are not supported in this study of a large number of patients.