Laboratory diagnosis
• Hb 5, reticulocytes 5, MCV 4 (> normal for age), WBC and platelets not 5.
• Red cells—normal morphology, have 4 i antigen positivity, 4 ADA activity.
• BM findings—usually absent erythroid precursors; other cell lines normal.
• No evidence of parvovirus infection.
• Radiological investigation to define other congenital defects. Differential diagnosis
• Transient erythroblastopenia of childhood (ffl followingsection; later presentation, transient, no other defects).
• Drugs, malnutrition, infection.
• Haemolytic anaemias in hypoplastic phase, with parvovirus B19, delayed recovery in HDN.
• Megaloblastic anaemia in aplastic phase.
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