Aetiology of Cytopenias in Children Admitted to a Tertiary Care Hospital

Abstract

Objective: To determine the aetiology of cytopenias (pancytopenia and bicytopenia) in children and to assess their relationship with demographic factors, clinical manifestations and disease outcome.
Patients and Methods: This cross-sectional study was carried out at the Children’s Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad from January 2015 to June 2016. Total of 154 children between the ages of 2 months to 12 years presenting with bicytopenia or pancytopenia, at the time of admission were enrolled in the study. Patients with known causes of cytopenias and those with chronic illnesses and on long term medications like chemotherapy or immunosuppressant were excluded.
Results: The causes of cytopenia in order of frequency were Acute Leukemia (25%), Aplastic Anemia (20%), Enteric fever (19%) and megaloblastic anemia (11%).Out of 38 Acute Leukemia patients, 61 % presented with bicytopenia and 39% with pancytopenia, whereas out of the 31 patients of Aplastic anemia, 29 (94%) presented with pancytopenia. Among 19 patients of enteric fever, 13(68%) had bicytopenia and 6 (32%) patients presented with pancytopenia. Total patients of megaloblastic anemia were 17 out of which 10 (59%) presented with bicytopenia and 7 (41%) with pancytopenia. All patients of Idiopathic Thrombocytopenic purpura ITP (N=9), Osteopetrosis (N=3), Amegakaryocytic thrombocytopenia (N=2), and Myelodysplastic syndrome (N=2) presented with bicytopenia.
Conclusion: The most common cause of cytopenia was found to be acute leukemia followed by aplastic anemia, enteric fever and megaloblastic anemia