Bhatnagar Shishir Kumar, Chandra Jagdish, Narayan Shashi, Sharma Sunita, Singh Varinder, Dutta Ashok Kumar
Department of Pediatrics and Pathology, Lady Hardinge Medical College & Associated Kalawati Saran Children's Hospital, New Delhi, India.
J Trop Pediatr. 2005 Aug;51(4):236-9. doi: 10.1093/tropej/fmi010. Epub 2005 Jul 13.
Pancytopenia is a common occurrence in pediatric patients. Though acute leukemias and bone marrow failure syndromes are usual causes of pancytopenia, etiologies such as infections and megaloblastic anemia also contribute. The aim of this study was to evaluate the clinico-hematological profile of varying degrees of childhood cytopenias with special reference to the non-malignant presentations. This is a retrospective study carried out in a tertiary care children's hospital. We retrospectively analyzed 109 pediatric patients who presented with pancytopenia for different etiologies. Acute leukemia (including ALL, AML and myelodysplastic syndrome) and aplastic anemia accounted for 21 per cent and 20 per cent cases respectively. Megaloblastic anemia was found in 31 (28.4 per cent) patients and was single most common etiological factor. Severe thrombocytopenia (platelet < or = 20 x 10(9)/l) occurred in 25.2 per cent of these patients. Various skin and mucosal bleeding occurred in 45.1 per cent of patients with megaloblastic anemia. Infections accounted for 23 (21 per cent) patients who presented with pancytopenia. Amongst infections, enteric fever occurred in 30 per cent patients. Malaria, kala-azar and bacterial infections were other causes of pancytopenia at presentation. The study focuses on identifying easily treatable causes such as megaloblastic anemia and infections presenting with pancytopenia. These conditions though look ominous but respond rapidly to effective therapy.
全血细胞减少症在儿科患者中很常见。虽然急性白血病和骨髓衰竭综合征是全血细胞减少症的常见病因，但感染和巨幼细胞贫血等病因也有一定影响。本研究的目的是评估不同程度儿童血细胞减少症的临床血液学特征，特别关注非恶性表现。这是一项在三级儿童专科医院进行的回顾性研究。我们回顾性分析了109例因不同病因出现全血细胞减少症的儿科患者。急性白血病（包括急性淋巴细胞白血病、急性髓系白血病和骨髓增生异常综合征）和再生障碍性贫血分别占病例的21%和20%。31例（28.4%）患者被诊断为巨幼细胞贫血，是最常见的单一病因。25.2%的患者出现严重血小板减少（血小板<或=20×10⁹/L）。45.1%的巨幼细胞贫血患者出现各种皮肤和黏膜出血。23例（21%）患者因感染出现全血细胞减少症。在感染患者中，30%为伤寒热。疟疾、黑热病和细菌感染是出现全血细胞减少症的其他原因。该研究重点在于识别易于治疗的病因，如巨幼细胞贫血和伴有全血细胞减少症的感染。这些病症虽然看似严重，但对有效治疗反应迅速。
