Zubair Abdullah Bin, Razzaq Mustafa Tauseef, Hashmi Abdul Wasey, Ali Syed Muhammad Yasir, Israr Muhammad Muneeb, Sadiq Saad Mustafa, Khan Muhammad Fahad, Haider Zaki, Sabir Muzammil, Kaneez Mehwish
Research, Mayo Clinic, Rochester, USA.
Pediatrics, Rashid Latif Medical College, Lahore, PAK.
Cureus. 2022 Aug 10;14(8):e27842. doi: 10.7759/cureus.27842. eCollection 2022 Aug.
Background The etiologies of pancytopenia in the pediatric age group remain exceedingly ubiquitous and warrant extensive hematological and interventional investigations like bone marrow biopsy. It varies widely from benign nutritional disorders to fatal malignancies. The present study aims to delineate the prevalence of various causes of pancytopenia in the pediatric population. Methods The present cross-sectional study included 96 patients between the age of one month till 15 years with pancytopenia. Study participants were evaluated for various parameters including their demographical details, clinical features, immunization history, and nature of the disorder. The prevalence of various etiologies (nutritional, neoplastic, infectious, autoimmune, and others) of pancytopenia was ascertained. Results Of the 96 patients, 42 (43.75%) were males with a mean age of 69.47 ± 7.12 months. Fever was present in 71.87%, arthralgias in 56.25%, weight loss in 35.41%, and failure to thrive in 18.75% of patients. The bone marrow examination revealed aplastic changes in 36 (37.50%), hyperplastic changes in 21 (21.87%), and normal cellularity in 40.62% of patients. Megaloblastic anemia was the most common nutritional cause of pancytopenia present in 21.85% of cases. Acute lymphoblastic leukemia (ALL) was the most prevalent neoplastic etiology present in 19.79% of patients. Aplastic anemia, miliary tuberculosis, parvovirus B19, and hemolytic anemia were other notable etiologies. Conclusion Megaloblastic anemia and infections like tuberculosis were common treatable etiologies of pancytopenia among the pediatric age group. ALL was the most common neoplastic etiology. Bone marrow biopsy remains crucial in elucidating the various neoplastic and nutritional etiologies of pancytopenia in children.
小儿全血细胞减少症的病因极为普遍,需要进行广泛的血液学及介入性检查,如骨髓活检。其病因范围广泛,从良性营养障碍到致命性恶性肿瘤不等。本研究旨在明确小儿全血细胞减少症各种病因的患病率。
本横断面研究纳入了96例年龄在1个月至15岁之间的全血细胞减少症患者。对研究参与者进行了各种参数评估,包括人口统计学细节、临床特征、免疫接种史及疾病性质。确定了全血细胞减少症各种病因(营养性、肿瘤性、感染性、自身免疫性及其他)的患病率。
96例患者中,42例(43.75%)为男性,平均年龄为69.47±7.12个月。71.87%的患者有发热症状,56.25%有关节痛,35.41%有体重减轻,18.75%有发育不良。骨髓检查显示,36例(37.50%)有再生障碍性改变,21例(21.87%)有增生性改变,40.62%细胞形态正常。巨幼细胞贫血是全血细胞减少症最常见的营养性病因,占病例的21.85%。急性淋巴细胞白血病(ALL)是最常见的肿瘤性病因,占患者的19.79%。再生障碍性贫血、粟粒性肺结核、细小病毒B19及溶血性贫血是其他值得注意的病因。
巨幼细胞贫血及结核病等感染是小儿全血细胞减少症常见的可治疗病因。ALL是最常见的肿瘤性病因。骨髓活检对于阐明儿童全血细胞减少症的各种肿瘤性及营养性病因仍至关重要。