English

Abstract

BACKGROUND Cytopenia is the most common condition in paediatric population which requires detailed haematological evaluation. The objective of this study was to understand the, aetiological factors of the three types of cytopenia (single cytopenia, bicytopenia, pancytopenia) in children. METHODS This study is a descriptive & retrospective 5 year study conducted in the Haematology wing of a paediatric tertiary health care centre in South India. Data of all cases who underwent detailed haematological evaluation like Complete blood count, peripheral smear and bone marrow examination for cytopenias during the study period were included in the study. RESULTS The study sample was 365. The total number of patients with single cytopenia (isolated anaemia / leukopenia / thrombocytopenia) was 240 (65.7 %), bicytopenia were 90 (24.6 %) and pancytopenia was 35 (9.58 %). There was slight female predominance (M: F = 1: 1.05). Bicytopenia and pancytopenia were commonly observed between 1 - 5 years of age, while single cytopenias were more common in 5 - 10-year age group. The analysis of symptoms and signs in all cytopenia groups showed petechiae / purpura as the most common presentation in single cytopenia. The analysis of clinical symptoms showed significant correlation (P value < 0.05). Single cytopenia was the most common observed type of cytopenia with Immune thrombocytopenic purpura as the commonest aetiologic factor. In the present study most common causes of bicytopenia were reactive conditions like ITP with and without anaemia, infections etc. Acute Lymphoblastic Leukaemia (ALL) was the most common aetiologic factor for pancytopenia (ANOVA test and Bonferroni test P value < 0.05). Isolated thrombocytopenia was the most common peripheral smear picture observed, followed by hypochromic microcytic picture and combination of hypochromic microcytic anaemia (HMA) with thrombocytopenia. CONCLUSIONS Children with cytopenias commonly have benign conditions than malignant conditions. Cytopenias due to primary haematological malignancies are more common than secondaries. KEYWORDS Bicytopenia, Cytopenia, Children, Aetiology, Paediatric Pancytopenia