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Suggest Treatment For PRCA In A 6 Month Old Child
Question: Hi,
My baby, 6.5 months old, was diagnosed with PRCA, suspected DBA when she was 2.5 months old. Usage of Wysolone (Prednisolone) 5 mg/day for 2.5 months did not improve situation.
Now our hematologist has bumped up the dosage of Wysolone to 10 mg/day and added Menabol 10 mg/day (Stanozolol).
I asked the doctor if this is quite high dose for the baby and side effects, he said treating the blood disorder to avoid transfusions outweighs the other risks.
Can some doctor share his opinions about adverse risks which my baby could have?
By the way, baby has been anemic from birth.
She has been reliant upon 15-20ml/kg PRBC-Leukofiltered-Irradiated blood transufsions once in every month.
My baby, 6.5 months old, was diagnosed with PRCA, suspected DBA when she was 2.5 months old. Usage of Wysolone (Prednisolone) 5 mg/day for 2.5 months did not improve situation.
Now our hematologist has bumped up the dosage of Wysolone to 10 mg/day and added Menabol 10 mg/day (Stanozolol).
I asked the doctor if this is quite high dose for the baby and side effects, he said treating the blood disorder to avoid transfusions outweighs the other risks.
Can some doctor share his opinions about adverse risks which my baby could have?
By the way, baby has been anemic from birth.
She has been reliant upon 15-20ml/kg PRBC-Leukofiltered-Irradiated blood transufsions once in every month.
Brief Answer:
Corticosteroid should be used but cautiously.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
I have gone through her all reports. Her bone marrow examination suggest pure red cell aplasia.
Transfusion is necessary in the treatment. It should be used as and when required.
PRCA in children should be observed and not treated aggressively to avoid corticosteroids related growth retardation.
Because in children PRCA is often transient and reversible.
She should also search for parvo B 19 infection and other hematological malignancy.
In idiopathic cases corticosteroids should be used. Response is seen in4 to 6 weeks mostly.
In refractory cases allogeneic peripheral stem cell transplantation is treatment of choice.
According to my opinion it should not be treated aggressively. If she have severe anemia then you should go for blood transfusion.
in multiple transfusion cases iron chelating agents can be used to avoid iron overload. So don't worry about that.
Moreover she is suspicious for DBA but it should be differentiated by transient erythroblastopenia of childhood.
So keep close watch on her blood count and don't treat it aggressively unless required.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Corticosteroid should be used but cautiously.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
I have gone through her all reports. Her bone marrow examination suggest pure red cell aplasia.
Transfusion is necessary in the treatment. It should be used as and when required.
PRCA in children should be observed and not treated aggressively to avoid corticosteroids related growth retardation.
Because in children PRCA is often transient and reversible.
She should also search for parvo B 19 infection and other hematological malignancy.
In idiopathic cases corticosteroids should be used. Response is seen in4 to 6 weeks mostly.
In refractory cases allogeneic peripheral stem cell transplantation is treatment of choice.
According to my opinion it should not be treated aggressively. If she have severe anemia then you should go for blood transfusion.
in multiple transfusion cases iron chelating agents can be used to avoid iron overload. So don't worry about that.
Moreover she is suspicious for DBA but it should be differentiated by transient erythroblastopenia of childhood.
So keep close watch on her blood count and don't treat it aggressively unless required.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Sir,
Thanks a lot for your response.
So do you say that the line of treatment being given to my baby is aggressive and you are against it?
Thanks, XXXXXXX
Thanks a lot for your response.
So do you say that the line of treatment being given to my baby is aggressive and you are against it?
Thanks, XXXXXXX
Brief Answer:
According to me its more aggressive.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your baby is treated well. Corticosteroids is the drug of choice. But it is little bit more aggressive and chance of corticosteroids related growth retardation should be kept in mind.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
According to me its more aggressive.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your baby is treated well. Corticosteroids is the drug of choice. But it is little bit more aggressive and chance of corticosteroids related growth retardation should be kept in mind.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Thanks a lot Sir. I will try to discuss this with my haematologist and see if we could get less aggressive.
One more question: While using allopathic line of treatment (corticosteroids/anabolic steroids), can we use homeopathic medication? I do understand that homeo is considered placebo by allopaths having no real effects, all that I want to understand is that whether using homeo medicine will have adverse reaction with steroids or nullify steroids' affect? And whether homeo can be given to babies?
I have found a person in XXXXXXX whose baby was also diagnosed with PRCA. They completely went with homeopathic medicine given by a doctor in XXXXXXX Incidentally their baby is in complete remission now. Of course this could be due to baby's own mechanism. But we just wish to try the homeopathic medication as well (in addition to allopathy). What is your take on this?
One more question: While using allopathic line of treatment (corticosteroids/anabolic steroids), can we use homeopathic medication? I do understand that homeo is considered placebo by allopaths having no real effects, all that I want to understand is that whether using homeo medicine will have adverse reaction with steroids or nullify steroids' affect? And whether homeo can be given to babies?
I have found a person in XXXXXXX whose baby was also diagnosed with PRCA. They completely went with homeopathic medicine given by a doctor in XXXXXXX Incidentally their baby is in complete remission now. Of course this could be due to baby's own mechanism. But we just wish to try the homeopathic medication as well (in addition to allopathy). What is your take on this?
Brief Answer:
It has no relation with steroids effects.
Detailed Answer:
Hi, dear
Homeopathic medicine to my knowledge has no interaction with steroids effect.
You should ask a homeopathic doctor about the effect of homeopathic medicine in PRCA. He is better person to say about that. It is out of my knowledge and scope.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic.
Wish you a very good health.
It has no relation with steroids effects.
Detailed Answer:
Hi, dear
Homeopathic medicine to my knowledge has no interaction with steroids effect.
You should ask a homeopathic doctor about the effect of homeopathic medicine in PRCA. He is better person to say about that. It is out of my knowledge and scope.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic.
Wish you a very good health.
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Above answer was peer-reviewed by :
Dr. Prasad
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