Sangita Kadu (Tehre)
Assistant professor, Department of Pathology, Dr Panjabrao Deshmukh alias Bhausaheb Memorial Medical College, Amravati.
Asha Harwani
Assistant professor, Department of Pathology, Dr Panjabrao Deshmukh alias Bhausaheb Memorial Medical College, Amravati.
Abstract
BACKGROUND: In our routine clinical practice, we frequently run into the clinical condition pancytopenia. All three of the blood's key components—red blood cells, white blood cells, and platelets—decline in pancytopenia. Pancytopenia is a decline in any two of the three blood cell lineages, which includes all three. These may also result from iatrogenic causes, such as certain medications, chemotherapy, or radiotherapy for cancer. Depending on the etiology, the bone marrow image can range from normocellular with subtle alterations to hypercellular with a complete replacement of malignant cells. Clinically, these can result in fever, pallor, infection, acute sickness, or even death depending on the cause, severity, and length of the impairment. For targeted treatment and prognostication, it's critical to understand the precise cause.
AIM: The aim of the study was to describe the different etiologies of pancytopenia in pediatric patients based on clinical and hematological profiles including peripheral blood and bone marrow examination
MATERIAL AND METHOD: The current study was an observational hospital-based investigation conducted at the Pathology Department. Before beginning this investigation, the institutional ethical committee gave its written consent. Thirty kids, of either gender, who were admitted to the hospital and met the inclusion requirements, were included in the study after receiving their parents' written, informed consent. All children between the ages of one month and fifteen years who were admitted to the hospital with pancytopenia met the inclusion criteria for this study. At the time of presentation, a thorough history, clinical examination, and hematological parameters were noted. Hemoglobin, red cell indices, total and differential leukocyte counts, platelet count, peripheral blood smear morphology, and bone marrow aspiration/biopsy were all part of the hematological profile.
RESULTS: During the study period, 30 children of age group 1 month to 15 years who presented with pancytopenia were studied. They consisted of 20 males and 10 females. Fever (88%) was the commonest symptom at presentation followed by bleeding manifestations (78.5%), abdominal pain (35.7%), and weight loss (43.3%). All children with pancytopenia had pallor 30 (100%). Other findings were splenomegaly (64.2%), hepatomegaly (59.5%), lymphadenopathy, and hyperpigmented knuckles (38%). The most common condition causing pancytopenia in our study was megaloblastic anemia 14 (46.67%), followed by acute lymphoblastic leukemia 5 (16.67%), and 3rd was aplastic anemia 2 (6.67%).
CONCLUSION: Pancytopenia is a frequent hematological disorder that doctors deal with on a daily basis in both inpatient and outpatient settings. Patients who report with generalized weakness, easily fatigued, pallor, and bleeding symptoms or pyrexia should be suspected of having pancytopenia. Pancytopenia can be diagnosed by aspiration cytology, biopsy, and bone marrow exams. Megaloblastic anemia was revealed to be the most frequent cause of pancytopenia in this series, despite the fact that aplastic anemia and leukemia are thought to be prevalent causes.
KEYWORDS: Anemia, Hematological profile, Pancytopenia and Thrombocytopenia