Pancytopenia In Children Research Articles

Bone marrow evaluation in a pediatric population with pancytopenia in a tertiary care children’s hospital of Nepal

Background: Pancytopenia, which is characterized by a triad of anemia, leukopenia, and thrombocytopenia, is frequently observed among the pediatric population. This study was carried out to determine the common etiologies of pancytopenia in children through bone marrow aspiration examination. Materials and methods: A one-year retrospective cross-sectional study of 64 cases of pancytopenia in the pediatric population was conducted at the Department of Pathology, Kanti Children’s Hospital, from July 2019 to June 2020. Results: 64 (35.55%) cases underwent bone marrow examination for pancytopenia. The patients' ages ranged from 4 months to 14 years, with a median age of 6.24±1.12 years. The majority of the patients fell into the age group of 1-5 years. The most common cause of pancytopenia was acute leukemia and hypoplastic bone marrow followed by erythroid hyperplasia, leishmaniasis, and megaloblastic anemia. Conclusions: Bone marrow examination is the fundamental diagnostic modality to diagnose the majority of cases of pancytopenia. It is important to consider acute leukemia, hypoplastic bone marrow, and leishmaniasis into account when evaluating pancytopenia in pediatric patients.

A Cross-Sectional Study of Etiology and Clinico-Hematological Profile of Pancytopenia in Children at Tertiary Care Centre in Western India

Objectives Pancytopenia is one of the most common blood disorders observed in routine clinical practice. There are few studies analyzing pancytopenia in Indian scenarios. This cross-sectional study is aimed to identify the cause of pancytopenia and analyze the clinico-hematological characteristics of children with pancytopenia in Western India. So this study was conducted to evaluate clinico-hematological profile of children presenting with pancytopenia and to determine the etiology of pancytopenia in Western India. Material and Methods This two-year descriptive cross-sectional study was conducted in a tertiary care referral hospital. All children with pancytopenia, ranging in age from 1 month to 18 years, were enrolled in the study. A thorough history was taken, as well as general and systemic examination findings, hematological parameters, and bone marrow examination findings were recorded. Results The age group of enrolled patients ranged from 1 month to 18 years in the 130 cases evaluated (63 males and 67 females), while the mean age was 9.8 years. Fever was the most prevalent symptom (n = 111, 85.40%), followed by generalized weakness and weight loss. Pallor was the most common physical manifestation, followed by knuckle pigmentation, hepatomegaly, and splenomegaly. Study results concluded that the most common cause of pancytopenia was megaloblastic anemia, followed by acute leukemia, aplastic anemia, and infections. Megaloblastic anemia can be distinguished from other causes of pancytopenia based on dietary habits, hematological parameters and serum B12 levels, potentially obviating the necessity for a bone marrow test in most pancytopenia patients. Conclusion In pancytopenia patients, detailed initial hematological investigations, including bone marrow examination, are beneficial for correct diagnosis. Although megaloblastic anemia is the most prevalent cause, other factors to examine include aplastic anemia, leukemia, Hemophagocytic Lymphohistiocytosis (HLH), hypersplenism, Systemic Lupus Erythematosus (SLE), and viral infections. When a complete history, clinical examination, and baseline hematological parameters are adequately assessed, bone marrow examination can be avoided in most pancytopenia patients.

Clinical and etiopathological profile of pancytopenia in children (1-18 years): A study from tertiary care center of Bundelkhand region, central India

Background: Pancytopenia is defined by a decrease in all three blood components, that is, leukopenia, thrombocytopenia, and anemia below the normal range. This study is an attempt to fill the lacunae regarding the information about pancytopenia in pediatric patients in the Bundelkhand region. The study aimed to study the clinical and etiopathological profile of pancytopenia in children (1–18 years) in the tertiary care center of the Bundelkhand region in central India. Materials and Methods: The present study was a hospital-based cross-sectional observational study conducted to learn about the clinical features, demographic and etiopathological profile of pancytopenia in children. The study was performed with 65 patients aged 1–18 years from September 2021 to August 2022 admitted to the Department of Paediatrics, Maharani Laxmi Bai Medical College and Hospital, Jhansi, and fulfilling inclusion criteria. IBM’s Statistical Package for the Social Sciences version 23 was used for the statistical study. Results: Out of 65 patients, a maximum number of cases were in the age group of 1–6 years (55%). Our study revealed male predominance over females with male-to-female ratio of 2.09:1, mostly belonging to rural areas. The most common presenting complaint was easy fatigue in (90%) of patients followed by fever (54%). The most common physical finding was pallor (100%), followed by splenomegaly and pedal edema (38%) and (18%), respectively. Bone marrow cellularity shows hypocellular marrow (62%), hypercellular (31%), and normocellular (7%). Peripheral smears of most of the patients showed normocytic normochromic (34%), followed by macrocytic hypochromic (30%). Regarding etiology megaloblastic anemia (30%) was reported as the most common cause of pancytopenia followed by malignancies (30%) including myelodysplastic syndrome (9%), multiple myeloma (3%), acute lymphocytic leukemia (9%), and acute myeloid leukemia (9%) followed by aplastic anemia (14%) and sepsis (8%). The study also shows other rare causes of pancytopenia such as disseminated tuberculosis (6%), malaria (9%), and dengue (3%). Conclusion: In the present study, the most common etiologies of pancytopenia come out as nutritional causes, that is, megaloblastic anemia followed by malignancies then aplastic anemia.

A study of etiological and clinico-hematological profile of pancytopenia in children in a tertiary care hospital

Background: Pancytopenia is a disorder in which all three major formed elements of blood are reduced below the lower limit of normal for the age and sex. Pancytopenia is a striking feature of many serious life-threatening illnesses ranging from simple drug-induced bone marrow hypoplasia, and megaloblastic anemia to fatal bone marrow aplasia and leukemias. In India, pancytopenia causes vary and still are more varied among the pediatric population. So, the present study was carried out to evaluate the various causes and clinic-hematological factors of pancytopenia in the pediatric age group. Methods: It was a hospital-based analytical cross-sectional study conducted in the department of pediatrics, SVPPGIP & SCB Medical College, Cuttack from September 2016 to October 2018. A total of 106 children between 6 months to 18 years with Pancytopenia were enrolled in our study. Bone marrow aspiration was conclusive in most of the cases. All data were analyzed using SPSS. Chi-square test was used to analyze any association and a p-value of <0.05 was considered significant. Results: Out of 106 patients, the majority were 10-14 years old. Female to male ratio was 1.4:1. The most common etiological factors were ALL (58.5%), Aplastic Anemia (19.8%), and others. Fever and Weight loss were the most common presenting symptoms. The most common signs were Pallor and Hepatomegaly. Conclusions: The present study concludes that detailed primary hematological investigations along with bone marrow aspiration are really helpful for understanding the disease process, diagnosing the etiology of pancytopenia, and helpful in planning further investigations and management of pancytopenia patients.

Ramifications of Pancytopenia in Children in a Tertiary Care Center in North Indian

BACKGROUND: Pancytopenia generally suggests the likelihood of bone marrow failure syndromes or leukemias. However, other easily treatable entities can also cause pancytopenia. To know the underlying cause of pancytopenia is essential for definite management and prognosis. AIM: The aim of this study is to study the prevalence, clinico-hematological profile, and etiology of pancytopenia in hospitalized children of 1 month to 18 years of age. METHODS: Descriptive study conducted in a tertiary care center included children of age 1 month to 18 years hospitalized with pancytopenia. Sociodemographic data, presenting complaints, and detailed history were noted. Detailed clinical examination and relevant investigations were done. RESULTS: The prevalence of pancytopenia was 2%. Majority of the patients were >10 years of age. Female: Male ratio was 1.15:1. The most common presentation was progressive pallor, followed by fever, icterus, and bleeding manifestations. The most common clinical examination finding was pallor, followed by splenomegaly, hepatomegaly, icterus, and lymphadenopathy. Macrocytic blood picture was most common, followed by microcytic, atypical cells, and normocytic picture. Mean serum ferritin (ng/ml) was 374.77 ± 1662.64. Mean serum B12 (pg/ml) was 117.72 ± 64.71. In bone marrow aspirate examination, megaloblastic erythropoiesis was most common, followed by normoblastic erythropoiesis, dual deficiency, malignant cells of lymphoid series, hypocellular marrow, and malignant cells of myeloid series. Megaloblastic anemia was the most common etiology, followed by dimorphic anemia amid acute leukemia. CONCLUSION: The study showed that megaloblastic anemia and infections (tuberculosis, dengue fever, and enteric fever) both of which are eminently treatable, cause nearly 65% of pancytopenia cases in pediatric patients.

Clinicoetiological profile of children with bicytopenia and pancytopenia

BackgroundBicytopenia, and pancytopenia have a wide etiological spectrum in children, ranging from viral infections to malignancies. There is limited data describing the clinicoetiological profile of bicytopenia and pancytopenia in children in recent times. MethodologyFifty children, aged 1 month to 12 years admitted with bicytopenia and pancytopenia were enrolled and evaluated. Basic patient information and clinical findings along with relevant investigations were obtained on a predesigned proforma and analyzed statistically. ResultsAmong the 50 cases studied, 46 had non-malignant causes, 24 (92.3%) cases had bicytopenia and 22 (91.66%) had pancytopenia. Among the 46 cases, 20 were infectious in origin. Sepsis was the commonest cause comprising 7 out of 20 cases (35%). Other causes included dengue fever, enteric fever, and malaria. The commonest cause of bicytopenia was nutritional anemia, observed in 8 out of 15 (53%) cases. The common causes of pancytopenia were megaloblastic anemia and aplastic anemia. Hematological parameters were significantly different among the bicytopenic and pancytopenic groups. MCH and MCHC were not significantly different between the groups. Hemoglobin and low white cell count were observed in aplastic anemia while thrombocytopenia was more marked in patients with megaloblastic anemia. A diagnosis of leukemia was made in 4 out of 50 cases, of which 2 each had pancytopenia and bicytopenia at presentation. ConclusionThe common causes of bicytopenia and pancytopenia were infections and nutritional deficiency. A history, examination and basic diagnostic tests were rewarding for the diagnosis in the majority.

Etiological Spectrum of Pancytopenia in Children of Southern Punjab

Background: Pancytopenia is an intermittent hematological finding in children presenting with erratic clinical features like fever, pallor, petechiae, bleeding, distended abdomen, failure to thrive. Aim: To evaluate the pattern of causes responsible for pancytopenia in children of southern Punjab. Study Design: Randomized control trail. Methodology: We enrolled 121 children, aged 1-15 years with pancytopenia after written informed consent for a period of one year in Pathology department of Children’s Hospital-Multan. Cell morphology was studied through microscopy on blood peripheral film and bone marrow aspiration film. The relevant investigations were performed to assess the pattern of causative agents in pediatric population of Southern Punjab, Pakistan. Data was presented as percentage through SPSS v20.0. Results: Fever, pallor and body-aches were the common (80%) clinical presentations in our patients. Mean ± SD age of patients was 7.1± 3.98 years. 56.50% of patients with pancytopenia had hyper-cellular marrow while 43.50% had hypo- cellular marrow. Aplastic anemia and Acute Lymphoblastic Leukemia were the common causes for pancytopenia. Conclusion: We concluded that aplastic anemia and ALL were the most common causes of pancytopenia in Southern Punjab, Pakistan. Infections and other treatable causes were also important causes of thrombocytopenia present in significant number (21.7%) of patients which we can address timely and reverse the serious outcomes. Keywords: Anemia, Bone Marrow, Megaloblastic and Pancytopenia.

Clinical Characteristics and Etiological Spectrum of Pancytopenia in Pediatric Age Group: A Cross-Sectional Outlook From a Developing Country.

BackgroundThe etiologies of pancytopenia in the pediatric age group remain exceedingly ubiquitous and warrant extensive hematological and interventional investigations like bone marrow biopsy. It varies widely from benign nutritional disorders to fatal malignancies. The present study aims to delineate the prevalence of various causes of pancytopenia in the pediatric population.MethodsThe present cross-sectional study included 96 patients between the age of one month till 15 years with pancytopenia. Study participants were evaluated for various parameters including their demographical details, clinical features, immunization history, and nature of the disorder. The prevalence of various etiologies (nutritional, neoplastic, infectious, autoimmune, and others) of pancytopenia was ascertained.ResultsOf the 96 patients, 42 (43.75%) were males with a mean age of 69.47 ± 7.12 months. Fever was present in 71.87%, arthralgias in 56.25%, weight loss in 35.41%, and failure to thrive in 18.75% of patients. The bone marrow examination revealed aplastic changes in 36 (37.50%), hyperplastic changes in 21 (21.87%), and normal cellularity in 40.62% of patients. Megaloblastic anemia was the most common nutritional cause of pancytopenia present in 21.85% of cases. Acute lymphoblastic leukemia (ALL) was the most prevalent neoplastic etiology present in 19.79% of patients. Aplastic anemia, miliary tuberculosis, parvovirus B19, and hemolytic anemia were other notable etiologies.ConclusionMegaloblastic anemia and infections like tuberculosis were common treatable etiologies of pancytopenia among the pediatric age group. ALL was the most common neoplastic etiology. Bone marrow biopsy remains crucial in elucidating the various neoplastic and nutritional etiologies of pancytopenia in children.

INCIDENCE OF VISCERAL LEISHMANIASIS AMONG PANCYTOPENIC PAEDIATRIC PATIENTS

Background: Visceral leishmaniasis (VL) is a parasitic infection caused by Leishmania donovani. The sting of a sand-fly transmits Leishmania to humans. VL can lead to morbidity and even death if there is a delay in diagnosis. The objective of this study was to find out patients with visceral leishmaniasis presenting as pancytopenia in paediatric population. Methods: This single centre-cross sectional study was conducted for eight months in Paediatric Department, Ayub Medical Complex Hospital, Abbottabad. After taking informed written consent from all patients fulfilling the inclusion criteria, history was taken, detailed clinical examination done and bone marrow biopsy performed to check the Leishmania Donovani (LD) in the marrow sample. The findings were recorded and analysed. Results: Among 159 children presenting with pancytopenia, VL was confirmed in bone marrow biopsy report of 21 (13.2%) children, 100 children (62.9%) were males and 59 (37.1%) were females with the mean age of 5.58±3.44 years. Conclusion: VL is not an uncommon cause of pancytopenia in the paediatric population and should always be considered in the aetiology of pancytopenia in children especially those belonging to risky areas and if travel history is positive for the Mediterranean area. As the condition is treatable and has many complications that may lead to death if diagnosis is delayed, so workup and management done in time can actually save life of patient. Pak J Physiol 2022;18(1):13?5

Aetiological Profiles of Pancytopenia in Children between 2 months to 12 years of AgeA Retrospective Study from a Tertiary Care Centre, Chennai, India

Introduction: Pancytopenia is a medical condition that generally exists among children in which the peripheral blood cell lineages are found to reduce in blood. The condition is diagnosed as a common haematological problem with an extensive differential diagnosis and vary according to the geographical distribution and genetic mutation. The condition is reversible and easily treatable if identified at the earliest. Aim: To determine the frequency of aetiological spectrum of pancytopenia in children between the age of 2 months to 12 years from Chennai, Tamil Nadu, India. Materials and Methods: A retrospective descriptive study was carried out at the Institute of Child Health, Madras Medical College, Chennai, Tamil Nadu, India, from January 2016 to December 2016. Out of 12,869 patients admitted, 91 children were identified with pancytopenia based on peripheral blood smear analysis. Complete blood count, peripheral smear, red blood cell indices, bone marrow examination, and serum vitamin B12 levels were analysed. The complete data was tabulated in Microsoft excel sheet and frequency(n) and percentage (%) analysis was performed. Results: Total of 91 children of pancytopenia (45 males and 46 females , aged from 6 months to 12 years) were included in the study and analysed. Majority of the pancytopenia children belonged to the age group of 1 to 6 years (40, 43.9%). The identified common clinical presentations for admission include the unexplained fever (82.92%), pallor (10.8%), and bleeding (9.79%). The common major aetiologies were megaloblastic anaemia (23, 25.2%), acute lymphoblastic leukaemia (17, 18.6%), and aplastic anaemia (12, 13.1%). Infections due to microorganisms in children also cause pancytopenia and there was one child each with the infectious symptoms due to Human Immunodeficiency Virus (HIV), tuberculosis, and Epstein-Barr Virus (HBV). Conclusion: Acute leukaemia and bone marrow failure were identified as the most common causes of pancytopenia in children. It is highly advisable to record the symptoms related with iron deficiency anaemia along with the symptomatic issues of certain viral and bacterial infections among children from the developing nations while diagnosing pancytopenia.

Imerslund-Grasbeck syndrome- a rare cause of megaloblastic anemia in an infant with homozygous mutation in CUBN gene: a case report and review of the literature

Megaloblastic anaemia is one of the important causes of pancytopenia in children and nutritional deficiencies of vitamin B12 and folate are the most common causes comprising 95% of these cases. Defects in absorption, transport and metabolism of vitamin B12 are well described, however, are very rare. We report a rare case of Imersland Grasbeck syndrome, in an infant who presented with pancytopenia, with defective absorption of B12-intrinsic factor complex at the ileum and defective tubular reabsorption of proteins in renal tubule due to same protein defect caused by mutations in two genes – CUBN (cubilin) and AMN (amnionless).

Etio-Hematological Profile and Clinical Correlates of Outcome of Pancytopenia in Children: Experience From a Tertiary Care Center in North India.

IntroductionPancytopenia is a clinical entity encountered in pediatric practice as a feature of various benign and malignant disorders. It describes the simultaneous presence of anemia, leucopenia and thrombocytopenia. Attempts to identify the correct etiology and gauging the severity of pancytopenia will help to determine the management and prognosis of the patients.ObjectivesTo study etio-hematological profile, clinical correlates and outcome of pancytopenia in Indian childrenMethodsThis prospective observational study of children with pancytopenia was conducted at a tertiary care center from August 2015 to July 2016. Clinical, hematological and bone marrow studies were performed and patients were followed for one year. The collected data were statistically analyzed.ResultsOut of 84 cases, the mean age at diagnosis was 70 (70.77±4.8) months. Bone marrows showed aplastic changes in 37% and hyperplasia in 14% of patients. In our study, most common causes were aplastic anemia, acute leukemia and nutritional anemia. During the first year of follow-up, 67% pancytopenics survived and 12% succumbed (rest discontinued treatment) with ~26% of aplastic anemia (7/27 cases) and 9% of acute leukemia (2/22 cases) not surviving. Anthropometric status of patients and severity in aplastic anemia were significantly associated (p < 0.05) with outcome.ConclusionThe data gathered support a complex picture for pancytopenia in our study population since both benign nutritional deficiencies and malignant hematological neoplasms were common. Bone marrow studies seem to be of salient use in delineating etiology. As the outcome is multifactorial, factors like anthropometry, hematological parameters have a bearing on prognosis.

Pancytopenia in children-clinical and haematological evaluation

Pancytopenia is characterised by anaemia, leukopenia and thrombocytopenia. The common causes of pancytopenia in children are acute leukemia, nutritional deficiency anaemia, aplastic anaemia, bone marrow suppression (by drugs and various infections etc) and myelophthisic anaemia. Complete examination of the patient along with routine haematological investigation is very important in establishing the various causes of pancytopenia.

Pancytopenia in children at hematology department, children hospital 1: clinico-haematological profiles and bone marrow examination – a case series

Objectives: To determine causes of pancytopenia in children via bone marrow aspiration at Hematology Department, Children hospital 1; clinical characteristics, time to diagnostic; peripheral blood smear and bone marrow examination. Sample: Children with pancytopenia and bone marrow examination performed, at Hematology Department, Children hospital 1, from July 2017 to May 2018. Design: Case-series study. Results: A total of 96 patients were admitted to our department for bone marrow aspiration for pancytopenia during the study period. The most common diagnosis was hemophagocytic lymphohistiocytosis (HLH), 58.3%, followed by acute lymphoblastic leukemia with 26.0% and acute myeloid leukemia with 4.2%. The median duration of diagnosis (from first symptom to bone marrow aspiration) was 13.5 days (range, 4–31 days) in malignancy, 10.5 days in HLH (range, 4–49 days), and 13 days in aplastic anemia or bone marrow hypoplasia (range, 8–23 days). The peripheral blood smear showed blasts CA/blast in 88.0% cases with leukemia. Bone marrow aspiration showed hypocellularity in 10.4%, normocellularity in 68.8%, hypercellularity in 20.8%. Conclusions: In our hospital the most common causes of pancytopenia were hemophagocytic lymphohistiocytosis followed by acute leukemia. Routinely following a panel of screening tests to all children with newly pancytopenia, including complete blood cell count and peripheral blood smear is recommended. Bone marrow aspiration should be considered early. A definitive diagnosis could be made based solely on a single bone marrow aspiration in a significant fraction of cases in pediatric pancytopenia; some cases may require clinical follow-up and/or repeat bone marrow aspiration/biopsy for definitive diagnosis.

Pancytopenia in children - clinical and hematological evaluation

Pancytopenia in children - clinical and hematological evaluation

A Spectrum of Hematological Disorders in Children with Pancytopenia Based on Bone Marrow Examination in a Tertiary Care Hospital.

IntroductionPancytopenia is a common presentation in the pediatric population. It is a manifestation of various diseases, and its etiology can be explained on the basis of bone marrow examination. The study aims to determine the etiological factors leading to pancytopenia via bone marrow examination in pediatric patients presenting in our hospital.Materials and methodsThis retrospective cross-sectional study was conducted in the Department of Pathology at a public sector tertiary care hospital. Data were recorded by convenience sampling from the patients’ database from January 2015 to April 2018. Patients aged 2 months to 15 years who had pancytopenia on peripheral blood smear and were admitted for bone marrow examination were included in the study. Patients who were beyond these age limits, diagnosed cases of aplastic anemia and leukemia, and those with a recent history of blood transfusion were excluded from the study. The analysis was done via the Statistical Package for Social Sciences (SPSS) v.23.0 (IBM SPSS Statistics, Armonk, NY, USA), and descriptive statistics were applied.ResultsOf 115 cases, 58 (50.4%) were males and 57 (49.6%) were females. Megaloblastic anemia was present in 32 (27.8%) patients, and it was the most common cause of pancytopenia. Non-malignant disorders were seen in 95 cases (82.6%) and malignant disorders were seen in 20 (17.4%) cases.ConclusionMegaloblastic anemia is the most common cause, and acute lymphoblastic leukemia is the most common malignant cause of pancytopenia in children. There was no significant gender predilection among causes of pancytopenia.

Clinic-etiological profile of pancytopenia in children: a tertiary care center based study of Kumaun region, India

Background: Pancytopenia is not a disease entity but a triad of findings in which all blood cell lineages i.e leukocytes, erythrocytes and platelets are reduced in blood .It is consequence of various medical conditions. Present study was conducted to assess the etiology, clinical profile and bone marrow morphology of pancytopenia.Methods: A cross sectional prospective study was carried out among 42 children of age between 1 to 15 year with pancytopenia. Blood samples of the patients were analyzed for complete blood count and peripheral smear along with presence and absence of immature cells and abnormal cells. In bone marrow examination, morphology of all cell’s lineage, cellularity, parasite and abnormal cells were scrutinized. Trephine biopsy was done if indicated. Special investigations were done to confirm the diagnosis.Results: Among the 42 cases studied, age of the patients ranged from 1 to 15 years with a slight male predominance. Most of the patients presented with generalized weakness and weight loss and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. The commonest cause for pancytopenia was megaloblastic anemia Among the non-haematological causes kala azar 5 (11.9%) is the leading cause in this study.Conclusions: The present study concludes that detailed primary haematological investigations along with bone marrow examination in pancytopenic patients are helpful for diagnosis and management. This study also suggests that megaloblastic anaemia, dimorphic anaemia and kala-azar should also be included in differential diagnosis of pancytopenia in this geographical area.

Congestive cardiac failure induced by antitubercular therapy in a child: A case report

Tuberculosis is a significant public health concern affecting people of all age groups in developing countries. Agranulocytosis and pancytopenia occurring in adult tuberculosis patients taking antitubercular therapy (ATT) are well known. In contrast, only a couple of reports are available in the literature documenting pancytopenia in children with tuberculosis receiving ATT. These have reported pancytopenia secondary to disseminated tuberculosis presenting as hemophagocytosis or due to drug-induced systemic lupus erythematosus. However, clinically significant pancytopenia in the absence of hemophagocytosis and secondary lupus along with concurrent hepatitis leading to congestive cardiac failure in pediatric age group as witnessed in the index patient occurring due to ATT has not been reported previously. This child developed severe anemia presenting as congestive cardiac failure requiring multiple packed red blood cell transfusions. This case reinforces the need for regular hematological and liver function test monitoring in children receiving ATT so as to prevent the development of complications such as congestive cardiac failure.

A prospective observational study on clinico-etiological profile of pancytopenia in children

A prospective observational study on clinico-etiological profile of pancytopenia in children

Pancytopenia in children: A 6-year spectrum of patients admitted to Pediatric Department of Rehman Medical Institute, Peshawar

To determine the various spectrum of pancytopenia with its frequency on the basis of bone marrow examination in children from 6 months to 14 years. A retrospective descriptive study was carried out at Department of Pediatric Rehman Medical Institute Peshawar from January 2006 to December 2012. A total of 205 patient's age between 6 months and 14 years, fulfilling the inclusion and exclusion criteria were included in the study. Complete blood count, peripheral smear, bone marrow examination and Serum vitamin B12 level was done in all the cases. Out of 14642 patients admitted to the Pediatric department during the study period, 205 (1.4%) patients were pancytopenic on their peripheral blood smear. Male outnumbered female with a ratio of 1.8:1. 42.5% of the patients were in the age group of 1 month to 5 years. Common etiological pattern identified were Aplastic anemia 58(28.3%), Hematological malignancies 49 (23.9%), megaloblastic anemia 40 (19.5%), idiopathic thrombocytopenic purpura 16 (7.8%), iron deficiency anemia 9 (4.4%), hemolytic anemia 7 (3.41%), Visceral leishmaniasis 6 (2.93%), hypersplenism 5 (2.44%), malaria 5 (2.44%), anemia of chronic disorder 4 (1.95%), Myelodisplastic syndrome 3 (1.46%), Niemen pick disease 2 (0.97%) and Gaucher disease in 1(0.49%). Common clinical presentations were fever, pallor, body aches, petechial hemorrhages and epistaxis. Pancytopenia is one of the importance occurrences in pediatric patients. Acute leukemia and bone marrow failure are the most common causes yet megaloblastic anemia and infections are the treatable and reversible causes of pancytopenia.