Anemia is prevalent among African American children. When evaluating pediatric patients for anemia, clinicians refer to the normative hematological reference values in reference textbooks. These reference values are used in spite of evidence that healthy African American people of all ages have average hemoglobin concentrations from 0.5 to 0.73 g/dl below those of Whites. In an earlier study, using samples from 2,161 healthy African American children from 2 to 18 years old, we found a statistically significant difference (P < 0.0001) in the mean hemoglobin value for each age group as compared to reference normative mean hemoglobin values. Here we present the results of a comparative analysis of the data set from our previous study and the data set from the National Health and Nutrition Examination Surveys III (NHANES III) 1988–1994. We found no statistically significant difference between these data sets with respect to the hemoglobin values for any age or sex group, confirming that African American children and adolescents have lower mean hemoglobin values than do Whites. Use of the reference hemoglobin values presented here will help prevent the misdiagnosis of anemia in African American children and thereby minimize unnecessary hematological workups and treatment. Am. J. Hematol. 82: 2007. © 2006 Wiley‐Liss, Inc.

Congenital malaria is reported rarely in the United States and almost exclusively affects infants of immigrant mothers. Because of its nonspecific presentation with fever during the first 3 months of life, it is an important differential diagnosis when evaluating such infants with fever in the pediatric emergency department. A complete and accurate travel and residency history on the infant's family should be sought during evaluation. As intercontinental travel and immigration increases, emergency department physicians should be alert to the diagnosis of malaria in ill neonates and young infants. We discuss a case of congenital malaria in a 26-day-old infant and review the clinical features of previously reported cases in the United States.

Essential thrombocythemia is a rare myleoproliferative disorder in pediatrics. This myleoproliferative disorder is characterized by excessive proliferation of megakaryocytes and sustained elevation of platelet count. Reactive thrombocytosis is a more common cause of elevated platelet counts among children. We describe a 2-year-old child with essential thrombocythemia, skeletal anomalies, and elevated thrombopoietin concentrations. The child's mother was also subsequently diagnosed with essential thrombocythemia and had elevated thrombopoietin concentrations. Chromosomal studies on the mother, child and other family members were normal.

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