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COVID-19-Associated Severe Aplastic Anemia in an 18-Month-Old Child: A Case Report
Hoor Hamidoglu1, Roa'a Abu Tawileh1, Hanan N Abouelkhel2,3
1Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, ARE.
Insights
This case study details a rare pediatric aplastic anemia linked to COVID-19 in an 18-month-old boy. Treatment with transfusions and romiplostim showed partial recovery, avoiding bone marrow transplant.
Area of Science:
- Hematology
- Pediatrics
- Infectious Diseases
Background:
- COVID-19 has emerged as a significant global health concern since late 2019.
- Hematologic abnormalities, including aplastic anemia, are increasingly recognized complications of COVID-19.
- Pediatric cases of COVID-19-associated aplastic anemia are exceptionally rare.
Abstract:
The COVID-19 pandemic has significantly impacted global health since its emergence in late 2019. Established evidence indicates an increasing incidence of hematologic abnormalities caused by COVID-19, such as aplastic anemia. Only a few pediatric cases have been reported. We present a previously healthy 18-month-old boy with fever, cough, diarrhea, rash, and ear discharge for one week. He was febrile, tachycardic, drowsy, with bilateral purulent ear discharge, petechiae, and cervical lymphadenopathy. Blood tests showed severe pancytopenia with high inflammatory markers, and SARS-CoV-2 PCR was positive. Bone marrow biopsy revealed severe aplastic anemia (<10% cellularity), and genetic testing excluded inherited causes. He was treated with blood transfusions and romiplostim. After one year of supportive management, the patient showed a partial response and improving counts, so bone marrow transplantation was deferred, with continued monitoring for sustained hematologic recovery or relapse.
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