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A case of red cell aplasia in a Negro child.

1966; BMJ; Volume: 41; Issue: 216 Linguagem: Inglês

10.1136/adc.41.216.213

1468-2044

Jamil Ibrahim, J. Rawstron, J. Booth,

Renal and related cancers

Up to 1964 128 cases of congenital red cell aplasia had been reported (Table ).All these were in Caucasian children and this was thought to be of genetic significance (Diamond, Allen, and Magill, 1961).Since then Khatua (1964) has described an 18-month-old Indian girl with red cell aplasia, whose chest radiograph showed an enlarged thymus gland, and who responded to steroids, while Shapiro, White, Diseker, and Bentley (1964) reported the condition in a negro girl with absent left kidney and ureter, who did not respond to steroids and who died at 4 months of age with pneumonia.The present report of pure red cell aplasia is of interest, as it is possibly the result of administering phenylbutazone to the mother in the later months of pregnancy, and is only the second case to be reported in a negro child.Case Report A female negro child of Jamaican parents, aged 3 months, was admitted to the Belgrave Hospital on January 20, 1964, with extreme pallor.Four weeks before admission she had diarrhoea which was treated for one week with oral streptomycin.There was no history of bleeding or jaundice, and no family history of anaemia.This was the mother's sixth pregnancy.At the 33rd week she had a painful elbow and was given phenylbutazone 200 mg.three times a day for 7 days.Delivery was normal at term, following artificial rupture of the membranes.The baby's birth weight was 8 lb. 10 oz.(3,920 g.).She was breast fed for 10 weeks.On admission she weighed 9 lb. 4 oz. (4,205g.) and had no abnormal facial characteristics.The spleen and liver were not enlarged and no lymph nodes were palpable.The heart was enlarged, with a haemic systolic murmur at the left stemal border.Investigations.Hb 2*0 g./100 ml. (14%): 30% Hb-A, 70% Hb-F (at age 14 months Hb-F 5% only): haematocrit 7%, MCHC 34%, reticulocytes 0-2%.WBCs 8,200/c.mm. (47% neutrophils, 45% lympho- cytes, 8% metamyelocytes).Ample platelets.Blood group A Rh positive.Sickling test negative.Direct