Clinico-etiological profile and outcomes of bicytopenia and pancytopenia in children at a tertiary care hospital

Abstract

Background: Bicytopenia and pancytopenia in children are haematological manifestations indicating underlying bone marrow dysfunction, peripheral destruction or systemic disease. The etiological spectrum in developing countries varies with nutritional deficiencies and infections playing a predominant role. There is limited data describing the clinicoetiological profile of bicytopenia and pancytopenia in children in recent times.

Methods: This is a cross-sectional observational study conducted at a teaching hospital, over a period of 18 months. A total of 110 children aged 1 month to 12 years (68 with pancytopenia, 42 with bicytopenia) were enrolled after obtaining informed consent. Basic patient information and clinical findings along with relevant investigations including complete blood count, peripheral smear, bone marrow examination and relevant biochemical and serological tests were done. Data was obtained on a predesigned proforma and analyzed using descriptive statistics.

Results: There was a male predominance (54.5%) with the majority (49%) in the 6–12-year age group. Fever (88.18%) was the most common presentation. The leading causes of cytopenia were infections 48 (43.6%) followed by nutritional deficiencies 43(39%). Other less common causes were primary haematological disorders that included acute leukaemia 11(10 %), thalassemia with hypersplenism 3 (2.72%), ITP 2 (1.8%) and aplastic anaemia 2 (1.8%).

Conclusions: Bicytopenia/pancytopenia is predominantly caused by treatable nutritional and infectious conditions with excellent prognosis. However, significant patients have life-threatening disorders like leukemia and aplastic anemia, which account for all mortality and morbidity.