Transient erythroblastopenia of childhood presenting with shock and metabolic acidosis

Transient erythroblastopenia of childhood is usually a benign, self-limiting underproduction of red blood cells that often goes undetected clinically. The patient presented here, however, required crystalloid boluses and red blood cell transfusion for treatment of shock and metabolic acidosis in the emergency department. The emergency physician must be alert to the patient presenting with severe anemia and procure extra pretransfusion blood samples for anemia studies when transfusion appears imminent. The need for red blood cell transfusion in such a patient must be expeditiously recognized and, when the need exists, transfusions should be started as quickly as possible.