A Spectrum of Hematological Disorders in Children with Pancytopenia Based on Bone Marrow Examination in a Tertiary Care Hospital

Zeeshan, Raana; Irshad, Bilal; Aslam, Muhammad Ammar; Khan, Muhammad Talha; Bhatti, Hamza Waqar; Chaudhary, Noman Ahmed

doi:10.7759/cureus.5124

Cited by 11 publications

(17 citation statements)

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“…12 Also similar study carried out by Vaidya et al found the most common age group was 21-30 years comprising 33.24 % of cases. 13 Similarly our results of age and sex ratio were comparable with other studies carried out by Thakkar et al, Manzoor et al, Yadav et al and Zeeshan et al [14][15][16][17] The study carried out by Lakhey et al in Nepal found weakness was the predominant presenting clinical feature in 73.9% cases. 18 Khodke et al studied 50 pancytopenia cases and found commonest presenting complaint was fever (40%) followed by weakness (30%) and bleeding manifestations (20%).…”

Section: Discussionsupporting

confidence: 90%

Clinico-hematological evaluation in cases of pancytopenia at tertiary care centre: largest cross-sectional study

2021

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Background: Pancytopenia is characterised by a reduction in all the three cellular elements of blood (erythrocytes, leukocytes and platelets) below the normal reference range leading to anaemia, leucopenia and thrombocytopenia. It is a feature of many serious conditions. The present study was conducted to assess aetiology, clinical profile and bone marrow morphology of conditions presenting with pancytopenia.Methods: A two years cross-sectional study from July 2017 to June 2019 was conducted in the Department of Pathology. Total of 300 pancytopenia patient were studied and their clinical features, peripheral smear finding and bone marrow morphology were studied by using marrow aspiration and biopsy.Results: Among 300 cases studied, maximum patients were in the age group 11-20 years (19.66%) with male (50.66%) predominance. Most of the patients presented with weakness (91.66%) and fever (56.66%) as chief complains. The commonest physical finding was pallor (94%) followed by splenomegaly (27.33%). Macrocytic anaemia (43.66%) was commonest peripheral finding. The commonest cause of pancytopenia was megaloblastic anaemia (32.66%) followed by dimorphic anaemia (21%), aplastic anaemia (16%) and acute leukaemia (13.33%).Conclusions: The present study concludes that detailed clinical history, primary haematological investigations along with bone marrow examinations is essential to determine the cause of pancytopenia.

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Section: Discussionsupporting

confidence: 90%

Clinico-hematological evaluation in cases of pancytopenia at tertiary care centre: largest cross-sectional study

2021

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“…[ 7 13 ] It can be observed from our study that megaloblastic anemia is a rare cause of pancytopenia in the pediatric age group, which is quite contrary to the study done by Zeeshan et al . [ 14 ] The incidence of kala-azar was 11.7% in the pediatric group in the study which makes it as the third leading cause of pancytopenia. The incidence of kala-azar is slightly higher than the study done by Naseem et al .…”

Section: Discussionmentioning

confidence: 97%

Hemorrhagic manifestation in different etiologies of pancytopenia

Singh

et al. 2021

Journal of Family Medicine and Primary Care

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Background: Pancytopenia is a triage of anemia, leukopenia, and thrombocytopenia. The etiology causing pancytopenia varies depending upon factors such as age, sex, occupation, and geographical distribution. Unfortunately, the major treatises of hematology have not given emphasis on the hemorrhagic manifestation of different etiologies causing pancytopenia. Objective: This observational study was carried out with the aim to identify hemorrhagic manifestation in patients with pancytopenia in eastern India. Design: This study was conducted over a period of two years at the Department of Medicine of a tertiary care teaching institute in eastern India. All the patients with features of anemia, thrombocytopenia, or leukopenia were screened for pancytopenia and a total of 214 cases were selected. Patients were divided into two groups as patients with age more than 14 years constitute group one and the patients less than 14 years constitute the second group. A detailed physical examination, hematological, and biochemical investigation was done to ascertain the hemorrhagic manifestations in pancytopenia patients. Results: In the groups, the most common cause of hemorrhagic manifestation in patients with pancytopenia was aplastic anemic, leukemia, myelodysplastic syndrome, and myelofibrosis. No bleeding manifestation was seen in patients with megaloblastic anemia, kala-azar, hypersplenism, and other causes of pancytopenia. Conclusions: Patients with pancytopenia caused by aplastic anemia, acute leukemia, and myelodysplastic syndrome have more chances of bleeding manifestation as compared with pancytopenia caused by megaloblastic anemia, kala-azar, or hypersplenism.

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“…Pancytopenia is not a disease but a clinicopathological entity that can occur due to several disorders that primarily or secondarily affect the bone marrow [4]. Literature shows that pancytopenia affects nearly 3% to 5% of children; however, the data from developing countries regarding the etiological spectrum are scarce [5].…”

Section: Introductionmentioning

confidence: 99%

“…Several infections including human immunodeficiency virus (HIV), miliary tuberculosis, leishmaniasis, and brucellosis can also cause pancytopenia among children [6][7][8]. Furthermore, some other factors like radiotherapy and chemotherapy can cause hypocellular bone marrow that leads to pancytopenia in children [5,9]. The spectrum of these etiologies is extremely varied and depends upon the geographical location, genetics, patient demographics, and nutritional profiles [10].…”

Section: Introductionmentioning

confidence: 99%

“…The initial investigation that is performed to confirm pancytopenia is the complete blood count (CBC). It will show hemoglobin (Hb) levels below 10 g/dL, platelet count lower than 100 × 10 3 /microL, total leukocyte count (TLC) under 4 × 10 9 /L, and absolute neutrophil count (ANC) below 1.5 × 10 9 /L [5]. Even though CBC is an important initial investigation, it cannot confirm the cause of pancytopenia.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics and Etiological Spectrum of Pancytopenia in Pediatric Age Group: A Cross-Sectional Outlook From a Developing Country

Zubair¹,

Razzaq²,

Hashmi³

et al. 2022

Cureus

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BackgroundThe etiologies of pancytopenia in the pediatric age group remain exceedingly ubiquitous and warrant extensive hematological and interventional investigations like bone marrow biopsy. It varies widely from benign nutritional disorders to fatal malignancies. The present study aims to delineate the prevalence of various causes of pancytopenia in the pediatric population. MethodsThe present cross-sectional study included 96 patients between the age of one month till 15 years with pancytopenia. Study participants were evaluated for various parameters including their demographical details, clinical features, immunization history, and nature of the disorder. The prevalence of various etiologies (nutritional, neoplastic, infectious, autoimmune, and others) of pancytopenia was ascertained. ResultsOf the 96 patients, 42 (43.75%) were males with a mean age of 69.47 ± 7.12 months. Fever was present in 71.87%, arthralgias in 56.25%, weight loss in 35.41%, and failure to thrive in 18.75% of patients. The bone marrow examination revealed aplastic changes in 36 (37.50%), hyperplastic changes in 21 (21.87%), and normal cellularity in 40.62% of patients. Megaloblastic anemia was the most common nutritional cause of pancytopenia present in 21.85% of cases. Acute lymphoblastic leukemia (ALL) was the most prevalent neoplastic etiology present in 19.79% of patients. Aplastic anemia, miliary tuberculosis, parvovirus B19, and hemolytic anemia were other notable etiologies. ConclusionMegaloblastic anemia and infections like tuberculosis were common treatable etiologies of pancytopenia among the pediatric age group. ALL was the most common neoplastic etiology. Bone marrow biopsy remains crucial in elucidating the various neoplastic and nutritional etiologies of pancytopenia in children.

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A Spectrum of Hematological Disorders in Children with Pancytopenia Based on Bone Marrow Examination in a Tertiary Care Hospital

Cited by 11 publications

References 4 publications

Clinico-hematological evaluation in cases of pancytopenia at tertiary care centre: largest cross-sectional study

Clinico-hematological evaluation in cases of pancytopenia at tertiary care centre: largest cross-sectional study

Hemorrhagic manifestation in different etiologies of pancytopenia

Clinical Characteristics and Etiological Spectrum of Pancytopenia in Pediatric Age Group: A Cross-Sectional Outlook From a Developing Country

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