Clinico-haematological profile and etiology of bi/pancytopenia in children aged six months to eighteen years

Authors

  • Rohan D. Venkat Department of Paediatrics, K. G. Patel Children Hospital, Vadodara, Gujarat, India
  • Sheela A. Bharani Department of Paediatrics, K. G. Patel Children Hospital, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20211086

Keywords:

Bicytopenia, Pancytopenia, Bone marrow aspiration

Abstract

Background: Bicytopenia/Pancytopenia is frequently found in our clinical practice having diverse etiologies, and still the optimal diagnostic approach remains undefined. Etiologies of bi/pancytopenia vary with genetic conditions, geographical area and the prevalence of infections and nutritional deficiencies in the community. The objective is to identify clinico-haematological profile and etiologies of bi/pancytopenia in children aged 6 months to 18 years from the region of western India.  

Methods: A descriptive cross-sectional study was done during May 2016 to April 2018. All patients were investigated for identifying a cause of bi/ pancytopenia. Pancytopenia is defined as haemoglobin of<10 gm%, total leukocyte count<4000/mm3 with or without absolute neutrophil count of<1500/mm3, platelet count<1 lac/mm3. Bicytopenia is defined as any reduction in any two cell lineages.  

Results: From 6109 hospitalized patients, 95 cases of bicytopenia and 79 of pancytopenia were evaluated. Fever, pallor, mucosal and skin bleeding were the predominant symptoms observed. Pallor was found in 90.8% cases followed by hepatomegaly in 64.8% and splenomegaly in 40.8% cases. From both bi/ pancytopenia groups, infective diseases were the common causes found in 87 (50%) cases, followed by malignancies in 28 (16%) cases and megaloblastic anemia in 22 (12.64%) cases. Aplastic anemia was found in 10 cases. Dengue fever and malaria were two common causes observed in bicytopenia group while megaloblastic anemia and acute lymphoblastic leukaemia were found in pancytopenia group.  

Conclusions: Infective diseases were common causes giving rise to bi/pancytopenia. Pancytopenia is predominantly noticed in the conditions related to bone marrow production or due to infiltrative disorders.

Author Biography

Rohan D. Venkat, Department of Paediatrics, K. G. Patel Children Hospital, Vadodara, Gujarat, India

Department of Pediatrics, Senior resident

References

Memon S, Shaikh S, Nizamani MA. Etiological spectrum of pancytopenia based on bone marrow examination in children. J Coll Physicians Surg Pak 2008;18(3):163-7.

Naseem S, Varma N, Das R, Ahluwalia J, Sachdeva MU, Marwaha RK. Pediatric patients with bicytopenia/pancytopenia: review of etiologies and clinico-hematological profile at a tertiary center. İndian J PatholMicrobiol. 2011;54:75-80.

Yadav S, Kushwaha R, Aggrawal K, Tripathi AK, Singh US, Kumar A. A clinico-hematological study in cases of pancytopenia: correlation of automated cell counter parameters in various etiologies. J Med Dent Sci 2013;2(22):4013-24.

Lakhey A, Talwar OP, Singh VK, KC SR. Clinico-hematological study of pancytopenia. J Patho Nepal 2012;2(3):207-10.

Chhabra A, Chander V, Patel A. Clinico-aetiological profile of pancytopenia in paediatric practice. J Indian AcadClin Med 2012;13:282-5.

Singh G, Agrawal DK, Agrawal R, Suthar PP. Etiological profile of childhood pancytopenia with special references to non-malignant presentation. Int J Med Res Prof 2016;2(2):204-8.

Dubey SR, Patel SK, Arya AK, Singh RP. Clinico-etiological spectrum of pancytopenia in hospitalized children. Int J Contemp Pediatr 2016;3(1):169-72.

Jan AZ, Zahid B, Ahmad S, Gul Z. Pancytopenia in children: A 6-year spectrum of patients admitted to Pediatric Department of Rehman Medical Institute, Peshawar. Pak J Med Sci 2013;29(5):1153.

Rathod GB, Alwani M, Patel H, Jain A. Clinico-hematological analysis of Pancytopenia in Pediatric patients of tertiary care hospital. Int Arch Integrat Med. 2015;2(11):15-9.

Ejaz MS, Latif N, Ahmed IR, Inkisar Ali SM. Etiological profile of pancytopenia in children: A hospital based study. Pak J Med Sci. 2011;27(2).

Sharif M, Masood N, Haq M Z, Dodhy MA, Asghar RM. Etiological Spectrum of Pancytopenia/ Bicytopenia in Children 2 Months to 12 Years of Age. J Rawal Med Coll 2014;18(1):61-4.

Gupta V, Tripathi S, Tilak V, Bhatia BD. A study of clinico-haematological profiles of pancytopenia in children. Trop Doct 2008;38(4):241-3.

Wu J, Cheng YF, Zhang LP, Liu GL, Lu AD, Jia YP, et al. Clinical features and etiological spectrum in children with pancytopenia. Zhongguo Dang Dai Er Ke Za Zhi 2011;13(9):718-21.

Manzoor F, Karandikar MN, Nimbargi RC. Pancytopenia: A clinico-hematological study. Med J DY Patil Univ 2014;7:25-8.

Bhatnagar SK, Chandra J, Narayan S, Sharma S, Singh V, Dutta AK. Pancytopenia in children: etiological profile. J Trop pediatr 2005;51(4):236-9.

Savage DG, Allen RH, Gangaidzo IT, Levy LM, Gwanzura C, Kiire C, et al. Pancytopenia in Zimbabwe. Am J Med Sci 1999;317(1):22-32.

Downloads

Published

2021-03-23

Issue

Section

Original Research Articles