Unusual transient erythroblastopenia in a nine year old boy

The case of erythroblastopenia in a nine-year old boy who was healthy prior to the rapid onset of anemia is presented. There was no previous personal or family history of anemia or congenital anomaly. The initial Hgb was 4.0 gram/dl requiring the need for PRBC transfusions; the MCV was elevated throughout the course of disease. Continued erythroblastopenia after 8 weeks of observation prompted treatment with prednisone to which the anemia rapidly responded; and hematologic values have remained normal more than 1 1/2 years after discontinuation of steroid therapy. The case is discussed in the context of a diagnostic differentiation between transient erythroblastopenia of childhood (TEC) and Diamond-Blackfan Anemia (DBA); since it does not clearly fit either category it could either be an unusual TEC presentation with extended macrocytic anemia dependent on steroid therapy for remission, or a late onset DBA with potential for eventual relapse.