Clinico-Etiological Spectrum of Pancytopenia in Children Presenting in Allied Hospital, Faisalabad

Abstract

Introduction: Pancytopenia is commonly encountered entity in paediatric patients characterized by reduction in the effective production of erythrocytes, leukocytes and platelets by bone marrow. Etiology includes infections, malignancies, bone marrow failure and nutrient deficiencies. Objectives: To determine the frequency of different clinical manifestations and etiological factors of childhood pancytopenia. Study Design: Descriptive study. Setting: Department of Paediatrics, Allied Hospital Faisalabad. Duration: Eight months from 01-08-2015 to 31-03-2016.Sample Size: total of 125 patients. Sampling Technique: Consecutive non-probability sampling. Data Collection Procedure: Patients with pancytopenia were enrolled and underwent detailed history and physical examination. Blood counts with peripheral smear, reticulocyte count, red cell indices, Vitamin B₁₂ and folate levels, blood culture, bone marrow examination and any other investigation required were done. All data was analyzed using SPSS version 20. Results: The mean age was between 7.69 ± 2.36 years with 54 male and 71 female patients. Leukemia was in 28% cases followed by lymphoma in 24%, aplastic anemia in 20%, megaloblastic anemia in 8%, enteric fever in 8%, malaria in 6.4% and sepsis in 5.6%. The commonest clinical presentation was fever in 92% cases followed by pallor in 83.2%, visceromegaly 64.8%, petechiae/bruises 42.4%, joint pain 29.6% and bleeding tendency 20.8%. Conclusions: Common etiologies found were malignancy and aplastic anemia, while megaloblastic anemia and infectious etiologies were less frequent. Common presentation was fever, pallor, bleeding tendency and visceromegaly.