Paediatric Haematology Flashcards
What are the differences in the normal blood parameters for children and for neonates?
Children:
- Higher lymphocyte count
- Lower haemoglobin
- Lower MCV
Neonates:
- Much higher neutrophil and lymphocyte count
- Higher haemoglobin
- Higher MCV
What can cause polycythaemia in neonates?
- Twin to twin transfusion syndrome
- Intrauterine hypoxia
- Placental insufficiency
What can cause anaemia in neonates?
- Twin to twin transfusion syndrome
- Foeto-maternal transfusion
- Parvovirus
- Haemorrhage
What is transient abnormal myelopoiesis?
This is a congenital leukaemia, associated with Down’s syndrome. It is usually transient but some children may become leukaemic later in life.
What is the screening for sickle cell disease?
Guthrie test
What is hand and foot syndrome?
It is ischaemia of the bone marrow. It can occur in distal bones due to a larger distribution of red bone marrow in the child’s skeleton. It is most likely to occur in younger children (<2 years).
What is splenic sequestration?
It can cause anaemia, shock and possible death. It is unique to younger children with sickle cell disease, as the spleen then dies and the patient becomes hyposplenic.
What are the infection risks for children with sickle cell disease? What is done to avoid this?
- Pneumococcus
- Parvovirus
Vaccines are given, with prophylactic penicillin.
How is sickle cell managed?
- Accurate diagnosis
- Educate parents
- Vaccinate
- Prescribe folic acid and penicillin
When does thalassaemia usually present?
In childhood, at 3-6 months as foetal haemoglobin wears off.
What are the effects of thalassaemia?
- Anaemia (HF, reduced growth)
- EPO drive (bone expansion, hepatosplenomegaly)
- Iron overload (HF, gonadal failure)
How is thalassaemia treated in children?
- Accurate diagnosis
- Blood transfusion
- Chelation therapy if they are iron overloaded
- Holistic approach to child
Name haemolytic anaemias of children
Inherited:
- Hereditary spherocytosis (red cell membrane defect)
- Hereditary elliptocytosis (red cell membrane defect)
- Sickle cell disease (Hb defect)
- Pyruvate kinase deficiency (glycolytic pathway defect)
- G6PD deficiency (pentose shunt defect)
Acquired:
- Autoimmune haemolytic anaemia
- Haemolytic uraemic syndrome
What are the differentials for easy bruising in children?
- Inherited thrombocytopaenia or platelet defect
- Acquired thrombocytopaenia or platelet defect
- NAI
- Henoch-Schonlein purpura
Name some coagulation defects in children
- Haemophilia A
- Haemophilia B
- von Willibrand disease
