Publication:

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.