Is Bone Marrow Examination Justified in Isolated Childhood Thrombocytopenia?

Abstract

Immune thrombocytopenic purpura (UP) is a common pediatric hematologic disorder. Bone marrow aspiration (BMA) is often performed in children with acute ITP to rule out leukemia, aplastic anemia or other hematologic diseases. However, whether BMA is needed in children with typical and hematological features of acute ITP has been questioned. To determine whether BMA is indicated in acute childhood ITP, samples were examined from 122 patients with the provisional diagnosis of acute ITP attending Hevi Pediatric Teaching Hospital, Duhok/North of Iraq between August 2006 and July 2010. Typical acute ITP was defined as an appearance of well being, no hepatosplenomegaly, no lymphadenopathy, normal Hb, WBC, neutrophil count and peripheral blood smear except for thrombocytopenia. A platelet count of 50 x109/L or lower was the cut-off level. No diagnoses of leukemia or aplastic anemia were revealed in the 122 (100%) children with typical hematologic features of ITP and it was concluded that routine BMA is not needed for children with typical features of acute ITP.