Down Syndrome Management
I have been reviewing the recent literature available
to pediatricians regarding the primary care managment of patients with
Trisomy 21. I have been unable to find a recommendation for screening blood
counts. The practice of general pediatrics does not include complete blood
counts for 'normal' patients at any point, though hematocrits are checked
on a schedule by some. The overall risk of malignant myelodysplasias in
is quoted generally at ~1%, which is low, but significantly increased
over the general childhood population.
My question is: is the risk of leukemia or leukemoid reaction in Trisomy
21 high enough that patients should have a screening CBC on some scheduled
basis (once every few months to some age then once annually?)? If not,
are the indications for diagnostic CBC in any way different from those
in non-Down children who are suspected to have leukemia?
Thanks for your help!
Angela Scheuerle M.D. firstname.lastname@example.org
"Without courage you cannot practice any other virtue
consistently" -Maya Angelou