Clinico Haematological Profile in Paediatric Patients with Bicytopenia and Pancytopenia in a Tertiary Care Referral Centre of North India: A Prospective Observational Study

Background: Bicytopenia and Pancytopenia are relatively common presentations in adults as compared to paediatric patients. Clinical features present in different manifestations in children with Pancytopenia/Bicytopenia, which can range from bone marrow suppression temporarily to marrow infiltration by life-threatening malignancies. The bone marrow findings may vary depending on the causative factors, from normocellular with non-specific changes to hypercellular being overshadowed by malignant cells.

Aim: To study the clinical and haematological profile in the paediatric age group with Cytopenias. The study aims to analyze the severity of hematological findings as per causative factors in patients with Pancytopenia and Bicytopenia.

Methods: Prospective Observational Study conducted in the Department of Paediatrics in Dr. RPGMC Tanda Himachal Pradesh (INDIA). The study included all patients except those falling in the exclusion criteria. It was performed after oral and written informed consent.A total of 50 children admitted with bicytopenia and pancytopenia were enrolled from March 2013 to March pancytopenia. Bicytopenia was seen in 14 (20%) and pancytopenia in 8 (16%) cases with infection. Scrub typhus was the commonest Infection seen in 18(32%).Leukaemia was notedin 11(22%) cases.

Conclusions: The commonest age group affected was 11-15 years with female domination with a Male: Female ratio of 0.78:1. The commonest symptom was fever 37(74%) then generalized weakness in 29 (58%) cases.Pallor was the most common sign in 43(86%) followed by Hepatomegaly 32(64%), Lymphadenopathy 30(60%), and Splenomeagly in 29 (58%) patients. Infection was the commonest etiology followed by leukemia and megaloblastic anaemia. Scrub typhus was the commonest infection encountered in the present study.