Page 249 - Abstract Book KONIKA 18

Hemato-Oncology

P-HO-042
Giardiasis Infection, Forgotten Cause of Iron Deficiency Anemia in Children:
A Case Report

Hanna Khairat, Hikari Ambara Sjakti, Fitri Primacakti
Departement of Child Health, Faculty of Medicine Universitas Indonesia/DR. Cipto Mangunkusumo General Hospital,
Jakarta, Indonesia

Abstract
Background Iron deficiency anemia is the most common cause of anemia in children globally with one of its
etiology is parasitic infection. Giardiasis as one of the parasitic infections can be asymptomatic in children.
Objective To demonstrate the importance of parasite fecal examination for diagnosing the etiology of iron
deficiency anemia in a child. Case A 11-years-old male child was brought to the hospital with recurrent
pallor for the last two years prior to admission. He had learning problem in class, complained being tired,
and fainted. He had no bleeding manifestation, no diarrhea, adequate nutritional intake with his nutritional
status was overweight and normal stature. He received recurrent blood transfusion. He then referred to the
hemato-oncology clinic in Cipto Mangunkusumo Hospital where blood smear, iron profile, fecal examination,
Coomb’s test, Glucose-6-Phosphate Dehydrogenase (G6PD) test, patient and parent’s hemoglobin analysis,
and bone marrow test had been done. The patient diagnosed with iron deficiency anemia but the treatment of
adequate iron therapy for two months didn’t show any improvement. The clinician later checked the parasite
fecal examination that showed Giardia Lamblia. Metronidazole 15 mg/kg/day and iron therapy was given
for seven days and his hemoglobin level was improved two weeks later. Iron therapy continue to be given
for five months and the patient didn’t look pale anymore after the treatment finished. Conclusion Parasite
fecal examination should always be performed in children with iron deficiency anemia.
Keywords: iron deficiency anemia; giardiasis, children

P-HO-043
Hematological Features of COVID-19 Infection in Children with Malignancies

Setya Puspa Dewi Aprilyani, Ariawan, Bambang Sudarmanto
Department of Child Health, Faculty of Medicine Universitas Diponegoro/Dr. Kariadi General Hospital,
Semarang, Central Java, Indonesia
Abstract
Background SARS-CoV2 can impair hematological functions and cause complications such as lymphopenia
and hypercoagulability, which are considered markers of poor prognosis. Patients with malignancies are
known to be highly immunocompromised by direct impact of immune system and treatment involving
significant myelosuppression and lymphocyte depletion. Data of hematological features in patients with of
COVID-19 and malignancies are limited. Objectives To describe the hematological features of COVID-19
infection in children with malignancies. Methods In this study, we included children with malignancies and
confirmed COVID-19 PCR test in Kariadi General Hospital from April 1st–June 30th 2021. Hematological
features were analyzed descriptively. Results Total of 28 patients were observed consisting of 12 moderate (6
Acute Lymphoblastic Leukemia (ALL), 2 Acute Myeloblastic Leukemia (AML), 2 non-Hodgkin lymphoma,
1 solid tumor, 1 suspect of malignancy), 7 severe (3 non-Hodgkin lymphoma, 2 ALL, 1 Chronic Myeloid
Leukemia (CML), 1 solid tumor), and 9 critically ill (2 ALL, 2 solid tumor, 1 non-Hodgkin lymphoma, 4
suspect of malignancy) based on WHO severity scale for Covid-19. All patients had anemia (10.29±2.80).
Patient with CML had lymphopenia (2%). Lymphopenia was rare in children than in adults, possibly due to
immature immune system or less severe manifestation of COVID-19 in this age group. Hypercoagulability
features showed increased D-dimer (4576.21±5004.79), but normal for other coagulation studies.
Conclusion Lymphopenia, a marker of severe disease, was only found in CML patient. Increased D-dimer
were found on all patients, showing hypercoagulability as a contributing factor towards severity.
Keywords: COVID-19; malignancy; hematological features

KONIKA XVIII Abstract Book 201