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P383 Transient postviral cytopenia in children: an experience of a tertiary paediatric clinic
  1. Ourania Alexandropoulou1,
  2. Lydia Kossiva1,
  3. Ioanna Zika3,
  4. Maria Giannaki2,
  5. JP Panagiotou1,
  6. Maria Tsolia1,
  7. Kyriaki Karavanaki1
  1. 12nd Department of Paediatrics, University of Athens, ‘PandA Kyriakou’ Children’s Hospital, Athens
  2. 2Microbiology Department, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece
  3. 3General Hospital, Agrinio,Greece

Abstract

Introduction Postinfectious cytopenia occurs commonly in paediatric practice.The differential diagnosis ranges from transient benign aetiology to a life threatening disease. Among the causes of transient postinfectious cytopenia, viral infections contribute to a great percentage.

Aims To identify the relationship of acquired cytopenias with febrile viral infections in childhood and assess their course and outcome.

Material-methods All 117 febrile children, 4.0±3.8 years old (range:0–14), admitted to the Paediatric Ward, who presented with cytopenia during a 3 year period, were investigated with indices of infection, cultures of biological fluids and serological tests.

Results In 52/117 (44.4%) cases a viral agent was identified. The identified viruses were as follows (CMV:3, RSV:2, EBV:7, Influenza A:5, Influenza B:9, Parainfluenza:2, Rubella:1, Mumps:6, HSV:5, HHV6:3, Coxsackie:1, ECHO:1, PARVO B19:5, Rota:1, Varicella:1). The patients’ mean±SD age was 4.2±3.9 years and their duration of fever was 3.4±2.4 days. Among them, 33/52 had neutropenia/leukopenia, 9/52 thrombocytopenia and the remaining 10 patients exhibited bi- or trilineage cytopenia. The mean±SD duration of cytopenia was 29.7±41.3 days (i.e.\<180 days, transient cytopenia).However in 2 patients with CMV infection, 2 with EBV and one with ParvoB19 infection, cytopenia lasted for more than 180 days (chronic cytopenia). In all age groups (0-2y, 2.1-5y,>5 years), cytopenia was mostly of mild or moderate severity.

Conclusions Common viral infections in previously healthy children may transiently affect one or more cell lines. Postviral cytopenia is benign, of short duration and of mild/moderate severity. However, in patients with severe combined cytopenia, further evaluation and a close haematological follow-up is necessary.

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