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Journal of Tropical Pediatrics Advance Access originally published online on July 13, 2005
Journal of Tropical Pediatrics 2005 51(4):236-239; doi:10.1093/tropej/fmi010
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© The Author [2005]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Original Papers

Pancytopenia in Children: Etiological Profile

Shishir Kumar Bhatnagar, Jagdish Chandra, Shashi Narayan, Sunita Sharma, Varinder Singh and Ashok Kumar Dutta

Department of Pediatrics and Pathology, Lady Hardinge Medical College & Associated Kalawati Saran Children's Hospital, New Delhi, India

Dr Jagdish Chandra, Flat no. 5, Lecturer Flats. Lady Hardinge Medical College Campus, Bangla Sahib Road, New Delhi 110001, India. E-mail <jagdish{at}pediaindia.net>.

Pancytopenia is a common occurrence in pediatric patients. Though acute leukemias and bone marrow failure syndromes are usual causes of pancytopenia, etiologies such as infections and megaloblastic anemia also contribute. The aim of this study was to evaluate the clinico-hematological profile of varying degrees of childhood cytopenias with special reference to the non-malignant presentations. This is a retrospective study carried out in a tertiary care children's hospital. We retrospectively analyzed 109 pediatric patients who presented with pancytopenia for different etiologies. Acute leukemia (including ALL, AML and myelodysplastic syndrome) and aplastic anemia accounted for 21 per cent and 20 per cent cases respectively. Megaloblastic anemia was found in 31 (28.4 per cent) patients and was single most common etiological factor. Severe thrombocytopenia (platelet ≤20 x 109/l) occurred in 25.2 per cent of these patients. Various skin and mucosal bleeding occurred in 45.1 per cent of patients with megaloblastic anemia. Infections accounted for 23 (21 per cent) patients who presented with pancytopenia. Amongst infections, enteric fever occurred in 30 per cent patients. Malaria, kala-azar and bacterial infections were other causes of pancytopenia at presentation. The study focuses on identifying easily treatable causes such as megaloblastic anemia and infections presenting with pancytopenia. These conditions though look ominous but respond rapidly to effective therapy.


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