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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