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

Aradhana Kankane, Vipin Kumar, Nupur Pandey, Om Shankar Chaurasia
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Abstract

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.
全血细胞减少症儿童(1-18岁)的临床和病因病理学特征:一项来自印度中部邦德尔坎德地区三级保健中心的研究
背景:全血细胞减少症的定义是三种血液成分均减少,即白细胞减少、血小板减少和贫血低于正常范围。本研究试图填补关于本德尔坎德地区儿童全血细胞减少症信息的空白。该研究旨在研究全血细胞减少症儿童(1-18岁)在印度中部邦德尔坎德地区三级保健中心的临床和病因病理学特征。材料与方法:本研究是一项以医院为基础的横断面观察性研究,旨在了解儿童全血细胞减少症的临床特征、人口学特征和病因病理学特征。该研究纳入了2021年9月至2022年8月在Jhansi Maharani Laxmi Bai医学院和医院儿科住院并符合纳入标准的65名年龄在1-18岁的患者。统计研究使用了IBM的Statistical Package for the Social Sciences version 23。结果:65例患者中,1-6岁年龄组最多(55%)。我们的研究显示男性优势于女性,男女比例为2.09:1,主要集中在农村地区。最常见的主诉是易疲劳(90%),其次是发热(54%)。最常见的生理表现是苍白(100%),其次是脾肿大和足部水肿(38%)和(18%)。骨髓细胞结构表现为低细胞骨髓(62%)、高细胞骨髓(31%)和正常细胞骨髓(7%)。大多数患者外周血涂片表现为正红细胞正色(34%),其次是大细胞低色(30%)。关于病因,巨幼细胞性贫血(30%)是全血细胞减少症最常见的原因,其次是恶性肿瘤(30%),包括骨髓增生异常综合征(9%)、多发性骨髓瘤(3%)、急性淋巴细胞白血病(9%)和急性髓性白血病(9%),其次是再生障碍性贫血(14%)和败血症(8%)。该研究还显示了全血细胞减少症的其他罕见病因,如播散性肺结核(6%)、疟疾(9%)和登革热(3%)。结论:在本研究中,全血细胞减少症最常见的病因是营养原因,即巨幼细胞性贫血,其次是恶性肿瘤,然后是再生障碍性贫血。
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