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

OBJECTIVE: Bone marrow examination is rarely required for the diagnosis of childhood anemia, and its diagnostic utility in this setting is unknown.

DESIGN: Marrow specimens from 25 children aged 11 days to 12 years were reviewed to determine the cause of unexplained anemia.

RESULTS: 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.

CONCLUSIONS: 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.