Ashida Mony Krishnan1, Selva Raja Siddharth Raman2, Lali Krishnan Rajan3
BACKGROUND
Cytopenia is the most common condition in paediatric population which requires
detailed haematological evaluation. The objective of this study was to understand
the, aetiological factors of the three types of cytopenia (single cytopenia,
bicytopenia, pancytopenia) in children.
METHODS
This study is a descriptive & retrospective 5 year study conducted in the
Haematology wing of a paediatric tertiary health care centre in South India. Data
of all cases who underwent detailed haematological evaluation like Complete blood
count, peripheral smear and bone marrow examination for cytopenias during the
study period were included in the study.
RESULTS
The study sample was 365. The total number of patients with single cytopenia
(isolated anaemia / leukopenia / thrombocytopenia) was 240 (65.7 %),
bicytopenia were 90 (24.6 %) and pancytopenia was 35 (9.58 %). There was
slight female predominance (M: F = 1: 1.05). Bicytopenia and pancytopenia were
commonly observed between 1 - 5 years of age, while single cytopenias were
more common in 5 - 10-year age group. The analysis of symptoms and signs in
all cytopenia groups showed petechiae / purpura as the most common
presentation in single cytopenia. The analysis of clinical symptoms showed
significant correlation (P value < 0.05). Single cytopenia was the most common
observed type of cytopenia with Immune thrombocytopenic purpura as the
commonest aetiologic factor. In the present study most common causes of
bicytopenia were reactive conditions like ITP with and without anaemia, infections
etc. Acute Lymphoblastic Leukaemia (ALL) was the most common aetiologic factor
for pancytopenia (ANOVA test and Bonferroni test P value < 0.05). Isolated
thrombocytopenia was the most common peripheral smear picture observed,
followed by hypochromic microcytic picture and combination of hypochromic
microcytic anaemia (HMA) with thrombocytopenia.
CONCLUSIONS
Children with cytopenias commonly have benign conditions than malignant
conditions. Cytopenias due to primary haematological malignancies are more
common than secondaries.
