A Cross-Sectional Study of Etiology and Clinico-Hematological Profile of Pancytopenia in Children at Tertiary Care Centre in Western India

Abstract

Pancytopenia is one of the most common blood disorders observed in routine clinical practice. There are few studies analyzing pancytopenia in Indian scenarios. This cross-sectional study is aimed to identify the cause of pancytopenia and analyze the clinico-hematological characteristics of children with pancytopenia in Western India. So this study was conducted to evaluate clinico-hematological profile of children presenting with pancytopenia and to determine the etiology of pancytopenia in Western India. This two-year descriptive cross-sectional study was conducted in a tertiary care referral hospital. All children with pancytopenia, ranging in age from 1 month to 18 years, were enrolled in the study. A thorough history was taken, as well as general and systemic examination findings, hematological parameters, and bone marrow examination findings were recorded. The age group of enrolled patients ranged from 1 month to 18 years in the 130 cases evaluated (63 males and 67 females), while the mean age was 9.8 years. Fever was the most prevalent symptom (n = 111, 85.40%), followed by generalized weakness and weight loss. Pallor was the most common physical manifestation, followed by knuckle pigmentation, hepatomegaly, and splenomegaly. Study results concluded that the most common cause of pancytopenia was megaloblastic anemia, followed by acute leukemia, aplastic anemia, and infections. Megaloblastic anemia can be distinguished from other causes of pancytopenia based on dietary habits, hematological parameters and serum B12 levels, potentially obviating the necessity for a bone marrow test in most pancytopenia patients. In pancytopenia patients, detailed initial hematological investigations, including bone marrow examination, are beneficial for correct diagnosis. Although megaloblastic anemia is the most prevalent cause, other factors to examine include aplastic anemia, leukemia, Hemophagocytic Lymphohistiocytosis (HLH), hypersplenism, Systemic Lupus Erythematosus (SLE), and viral infections. When a complete history, clinical examination, and baseline hematological parameters are adequately assessed, bone marrow examination can be avoided in most pancytopenia patients.