Publication:

Study of etiological spectrum and clinico-hematological profile of children with bicytopenia and pancytopenia at a tertiary centre of Chhattisgarh: a cross-sectional study

Background Early and accurate identification of etiologies of bicytopenia or pancytopenia is vital to prevent complications, initiate timely therapy and improve outcomes in affected children. There are many studies in literature in children with pancytopenia, but there are only few studies in literature in children with bicytopenia. So far, no study has been done in children with bicytopenia and pancytopenia in Chhattisgarh.

Methods Prospective observational study was carried out among 100 cases. All children in the age group of 6 months to 14 years and who had pancytopenia defined as Haemoglobin<10 gm%, White blood cells <4000/mm3 with or without absolute neutrophil count <1500/mm3, platelet count <1lac/mm3 or bicytopenia defined as any reduction in any two cell lineages, were included.

Results Majority belonged to the age group of 6-10 years viz. 50% with bicytopenia and those with pancytopenia belonged to the age group of 1-5 years i.e. 36.4%. Males were slightly more than females. Those with pancytopenia, the male to female ratio was equal. But those with bicytopenia, the males were more than females. The mean hemoglobin, MCV, MCH, MCHC, RDW was significantly lesser in those with bicytopenia. The mean TLC, platelet count, was significantly more in those with bicytopenia. The proportion of microcytic hypochromic and normocytic normochromic was comparable in two groups. Those with benign haematological disorders were significantly more in bicytopenia group compared to pancytopenia group. Other diseases/disorders were comparable in two groups. The outcome was comparable in two groups.

Conclusions Bicytopenia was more common than pancytopenia and had a better prognosis. Most common etiology was SCD, Beta-thalassemia, spectrum ranging from infectious (malaria) to malignancy (leukemia). The causes reported in our study are determined by geographical locale of hospital, prevalence of malnutrition and regional occurrence of certain disease including malaria.