Acquired pure red cell aplasia in a child.

Primary acquired pure red cell aplasia is a rare occurrence in childhood. An eleven-year old boy presented to us with pallor, which required multiple packed red cell transfusions. He did not have hepatosplenomegaly, jaundice or lymphadenopathy. Bone marrow examination revealed the diagnosis of pure red cell aplasia. All possible investigations were done to exclude secondary causes of pure red cell aplasia. No secondary cause was found on investigations. Rheumatoid factor and anti-nuclear antibodies were positive. He was started on oral steroids, to which he did not respond. He was then given cyclosporine A. Response to cyclosporine was dramatic and the child now does not require any transfusions.

Study of 'at risk' factors in rural under five children.

1. In the present hospital based cross sectional study, 64.97% under five children in rural area were found to be 'at risk'. 2. The most common 'at risk' factor found in these under five children was weight below 70% of the reference (39.1%) followed by acute gastroenteritis and respiratory infections (19.3%), spacing of less than 2 years (13.2%) and working mothers where the child was being looked after by a substitute (12.2%). 3. More than one 'at risk' factors were found in 43 (21.8%) children. 4. Statistically significant association was found between 'at risk' children and illiteracy and poverty.