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Study of Clinicoetiological Spectrum of Bicytopenia and Pancytopenia in Hospitalized Children
Gaurav Kumar1, Sarita Verma1, Sanjay Chavan1
1Pediatrics, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND.
Insights
Infections are the most common cause of bicytopenia and pancytopenia in hospitalized Indian children. Most cases have treatable causes and favorable outcomes.
Area of Science:
- Pediatric Hematology
- Clinical Medicine
- Epidemiology
Background:
- Cytopenias in children, including bicytopenia and pancytopenia, have diverse causes, from infections to bone marrow failure.
- Timely diagnosis and treatment are crucial for favorable outcomes in pediatric cytopenias.
- Limited data exists on the etiology of cytopenias in hospitalized Indian children, particularly regarding severity associations.
Purpose of the Study:
- To investigate the etiological profile of bicytopenia and pancytopenia in hospitalized children at a tertiary care center in India.
- To analyze the association between the severity of cytopenia and its underlying etiology.
- To provide data on the common causes and outcomes of pediatric cytopenias in this specific population.
Main Methods:
- A cross-sectional observational study was conducted on 202 hospitalized children diagnosed with bicytopenia or pancytopenia.
- Patient data, clinical findings, and investigations were collected using predesigned pro forma.
- Statistical analysis was performed to determine etiological frequencies and associations.
Main Results:
- Infections were the most frequent cause (65.84%), followed by benign hematological disorders (18.81%), systemic illnesses (10.39%), and malignancies (4.95%).
- Pancytopenia cases exhibited more severe cytopenia compared to bicytopenia cases.
- The study observed a male predominance (1.65:1) and affected the pre-adolescent age group (6-12 years) most commonly.
Conclusions:
- Infections are the predominant etiology of bicytopenia and pancytopenia in hospitalized Indian children.
- The degree of cell line involvement can aid in diagnosing the cause of cytopenia.
- The majority of pediatric cytopenias in this cohort were associated with treatable conditions, leading to favorable prognoses.
Abstract:
Background The etiological profile of children with bicytopenia and pancytopenia has a very wide spectrum, ranging from transient causes like infections or nutritional deficiencies to bone marrow failure syndromes. Timely diagnosis and treatment impart favorable prognosis to this entity. There is a paucity of data regarding the etiology of cytopenia in hospitalized children at a tertiary center in India. Additionally, only a few studies have discussed the possible association between the severity of cytopenia at presentation and the possible etiology. Methods This is a cross-sectional observational study analyzing bicytopenia and pancytopenia in hospitalized children. Patient details, along with clinical findings and relevant investigations, were recorded on predesigned pro forma and analyzed statistically. Results Out of 202 children, 174 (86.13%) had bicytopenia, and 28 (13.86%) had pancytopenia, with a male predominance resulting in a male-to-female ratio of 1.65:1. The commonest age group affected was pre-adolescent age group (6-12 years). The causes of bicytopenia and pancytopenia in hospitalized children in the decreasing order of frequency were infections (65.84%), benign hematological disorders (18.81%), systemic illness (10.39%), and malignancies (4.95%). The cytopenia was more severe in children with pancytopenia than bicytopenia. Conclusions Infections outweigh the other causes of bicytopenia and pancytopenia. The severity of the cell line affected can help narrow down a diagnosis of cytopenia etiologies. Most of the children with bicytopenia and pancytopenia had treatable etiology and favorable outcomes.
