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Pancytopenia in hospitalized children: a five-year review
Meghann Pine1, Andrew W Walter
1Department of Pediatric Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN 37232-2573, USA. meghann.s.pine@vanderbilt.edu
Insights
Infections are the leading cause of pancytopenia in hospitalized children in the US. This finding differs from global data, highlighting the need for updated diagnostic guidance for pediatric pancytopenia.
Area of Science:
- Pediatric Hematology
- Infectious Diseases
- Clinical Medicine
Background:
- Pancytopenia in hospitalized children is rare and its causes vary globally.
- Limited data exists on pancytopenia etiologies in developed countries.
- This study addresses the gap by examining cases in a US children's hospital.
Purpose of the Study:
- To identify and analyze the causes of pancytopenia in hospitalized children in the United States.
- To provide a basis for improved evaluation and care of pediatric pancytopenia.
Main Methods:
- Retrospective chart review of children aged 2 months to 18 years admitted over a 5-year period.
- Pancytopenia diagnosis confirmed by laboratory evidence of neutropenia, anemia, and thrombocytopenia.
- Etiologies and patient characteristics were systematically reported.
Main Results:
- Sixty-four children with pancytopenia were identified.
- Infectious causes accounted for the majority (64%) of cases.
- Hematologic (28%) and miscellaneous (8%) etiologies were less common.
Conclusions:
- Infections are the most frequent cause of non-cancer-related pancytopenia in hospitalized children in the US.
- Findings contrast with international reports where megaloblastic anemia is often primary.
- This review offers guidance for diagnosing pediatric pancytopenia.
Background:
Pancytopenia in hospitalized children is not a common occurrence. The causes may vary in different patients and in diverse areas of the world. There are no reports in the literature describing these etiologies in a developed country. Our review focused on children presenting with pancytopenia at a children's hospital in the United States with the purpose to allow us to better evaluate and care for children.
Procedure:
Charts of children aged 2 months to 18 years who were admitted to our hospital over a 5-year period were retrospectively reviewed to identify the diagnosis of pancytopenia. The diagnosis of pancytopenia was confirmed by laboratory values showing neutropenia, anemia, and thrombocytopenia. These etiologies and patient characteristics were reported in our review.
Results:
A total of 64 children were identified with the diagnosis of pancytopenia. The most common diagnoses were infectious in origin (64%), followed by hematologic (28%), and miscellaneous (8%) etiologies.
Conclusions:
The most common etiology of pancytopenia in hospitalized children without cancer was infections. This differs from earlier reports in other countries, where megaloblastic anemia was found most often. Our review should provide guidance to the diagnoses which should be considered when evaluating a child with pancytopenia.
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