All issues > Volume 27(12); 1984

Original Article

J Korean Pediatr Soc. 1984;27(12):1192-1201. Published online December 31, 1984.

Clinical Study of Childhood Aplastic Anemia.

Sung Won Kim¹

¹Department of Pediatrics，St. Benedict Hospital，Busany Korea

Abstract

The author reviewed the clinical findings of the 53 children diagnosed as aplastic anemia at the pediatric department of St. Benedict Hospital and W.M. Baptist Hospital, Busan, during a period of 12 years from January 1971 to December 1982. The results were summarized as follows: 1) Among the 53 children with aplastic anemia, the ratio between male and female was1.4 : 1. The male was more frequent than female. This male dominant trend reaches peak at 3.0 ： 1 in the age group under 5 years old. The incidence was 35.9% among the age group from 5 to 10 years old, 34. 0% from 10 to 15 years old, and 30.1% below 5 years old. There was no significant differences on all age groups. 2) There were 3 cases of congenital origin, 7cases of secondary origin and 43 cases were unknown etiology. Among the 7 cases of secondary origin, 3 cases were due to chloramphenicol and 3 cases of hepatitis, and 1 case benzene. 3) The chief complaints on admission were as in orders: Pallor in 37 cases(69.8%), nasal bleeding and petechia each 20 cases respectively, fever in 13 cases(24.5%) et al. The physical examination on admission was cardiac murmur in 42 cases(79.2%), hepatomegaly in 15 cases (28.3%)，lymphnode enlargement in 4 cases(7.5%) and splenomegaly in 2 cases(3.8%) in order of frequency. 4) The majority of types of hemorrhage during the follow-up period was subcutaneous in 45 cases(84.9%) and nasal bleeding in 39 cases(79.6%). 5) The majority of duration of clinical manifestation on admission was less than 2 months in 41 cases(77.4%) but there was over than 6 months in 4 cases(7.5%). 6) The peripheral blood findings showed pancytopenia in 47 cases(88.7%), anemia and thrombocytopenia in 5 cases(9.4%), and anemia and leukopenia in 1 case(l. 9%). Hemoglobin level was under 8.0 gm% in 51 cases(96.2%), leukocjrte under 5,000/mm3 in 49 cases (92.5%), and platelet under 50,000/mm3 in 41 cases(77.4%). Bleeding time by Ivy method was prolonged over 5 min. in 79.2%. 7) The findings of bone marrow aspiration on admission were hypocellular in 49 cases (92.5%), normocellular in 1 case(l. 9%), hypercellular in 1 case(l. 9%) and unknown in 2cases(3.8%). 8) The treatment of aplastic anemia consisted of blood transfusion, prednisolone and testosterone. The 21 cases of follow-up evaluation revealed that death was in 8 cases(38.1%), remission in 7 cases(33.1%) and stationary states in 6 cases(28.6%). The majority of causes of death among 8 cases by follow-up evaluation was infection in 4 cases(50.0%) and hemorrhage in 3 cases(37.5%). The duration from onset to death was under 6 months(87.5%).

Keywords :Aplastic anemia.