Hematologic Manifestations of Childhood Illness

Published on 04/03/2015 by admin

Filed under Hematology, Oncology and Palliative Medicine

Last modified 04/03/2015

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Chapter 68 Hematologic Manifestations of Childhood Illness

Table 68-1 Normal Hematologic Values in Childhood

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aPTT, Activated partial thromboplastin time; Hb, hemoglobin; Hct, hematocrit; MCV, mean corpuscular volume; PT, prothrombin time; RBC, red blood cell.

* The normal range for the PT and APTT varies between laboratories. The time at which normal adult values are attained is 1 week for the PT and 2 to 9 months for the APTT. The platelet count is within the adult range from birth.

Data from Rudolph AM, Hoffman JIE, eds: Pediatrics, ed 17, East Norwalk, Conn, Appleton-Century-Crofts, 1982, p 1036, and from Nathan DG, Oski FA, eds: Hematology of infancy and childhood, ed 3, Philadelphia, WB Saunders, 1987, p 1679.

Table 68-2 Preliminary Diagnostic Guidelines for Macrophage Activation Syndrome in Systemic Juvenile Idiopathic Arthritis*

Laboratory Criteria
Clinical Criteria
Histopathologic Criterion
Evidence of macrophage hemophagocytosis in the bone marrow aspirate
Diagnostic Rule
The diagnosis of MAS requires the presence of any two or more laboratory criteria or of ≥2 clinical or laboratory criteria. A bone marrow aspirate for the demonstration of hemophagocytosis may be required only in doubtful cases.

MAS, Macrophage activation syndrome.

*The suggested criteria are useful only in patients with active systemic-onset juvenile idiopathic arthritis. The laboratory thresholds are examples only and are not specific for the diagnosis.

From Ravelli A, Magni-Manzoni S, Pistorio A, et al: Preliminary diagnostic guidelines for macrophage activation syndrome complicating systemic juvenile idiopathic arthritis. J Pediatr 146:598, 2005.