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

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.