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小儿全血细胞减少症的临床病因学剖析:一项在三级医疗中心开展的前瞻性研究

Investigating the Clinico-Etiological Profile of Pediatric Pancytopenia: A Prospective Study in a Tertiary Care Center.

作者信息

Nadig Neha Dattatreya, Rajan Priyank, Kolahalam Venkata Sai Kiran, Peddi Shreya, Rathi Tanisha, Choudhary Lakshya, Agrawal Mohit, Lohakare Tejaswee, Mittal Gaurav

机构信息

General Medicine, Adichunchanagiri Institute of Medical Sciences, B.G Nagara, IND.

Paediatrics and Child Health, Bombay Hospital Institute of Medical Sciences, Mumbai, IND.

出版信息

Cureus. 2024 Aug 26;16(8):e67875. doi: 10.7759/cureus.67875. eCollection 2024 Aug.

Abstract

Background A decrease in red blood cells, white blood cells, and platelets is known as pancytopenia, and it is frequently caused by a variety of illnesses such as bone marrow failure, malnutrition, infections, autoimmune diseases, or blood malignancies. The purpose of this study was to investigate the hematological, clinical, and causative aspects of pancytopenia in children ranging in age from one month to 18 years. Methodology At the Department of Pediatrics, a 12-month prospective observational research involving 70 pediatric patients with pancytopenia was carried out. Documentation included demographic information, clinical manifestations, history of vaccinations, and particular disease features. The study evaluated the frequency of several reasons (autoimmune, neoplastic, nutritional, infectious, and others) that lead to pancytopenia. Results The mean age of the 70 patients was 5.08 ± 3.22 years, comprising 30 males (42.86%) and 40 females (57.14%). Fever (50 cases, 71.43%), arthralgias (39 cases, 55.71%), weight loss (11 cases, 15.71%), and failure to thrive (13 cases, 18.57%) were among the most common symptoms. Examinations of the bone marrow revealed that 29 patients (41.43%) had aplastic alterations, 20 patients (28.57%) had hyperplastic abnormalities, and 21 patients (30%) had normal cellularity. Fourteen patients (20%) had nutritional reasons, mostly megaloblastic anemia, and six patients (8.57%) suffering from neoplastic disorders had acute lymphoblastic leukemia (ALL). Hemolytic anemia, parvovirus B19, miliary tuberculosis (TB), aplastic anemia, and systemic lupus erythematosus were among the other noteworthy etiologies. Conclusion Many cases of pediatric pancytopenia in the region are preventable. Greater awareness and appropriate diagnostic strategies are crucial for the early identification and management of these conditions.

摘要

背景 红细胞、白细胞和血小板减少被称为全血细胞减少症,它通常由多种疾病引起,如骨髓衰竭、营养不良、感染、自身免疫性疾病或血液恶性肿瘤。本研究的目的是调查1个月至18岁儿童全血细胞减少症的血液学、临床和病因学方面。方法 在儿科进行了一项为期12个月的前瞻性观察研究,涉及70例全血细胞减少症儿科患者。记录包括人口统计学信息、临床表现、疫苗接种史和特定疾病特征。该研究评估了导致全血细胞减少症的几种原因(自身免疫性、肿瘤性、营养性、感染性等)的频率。结果 70例患者的平均年龄为5.08±3.22岁,其中男性30例(42.86%),女性40例(57.14%)。发热(50例,71.43%)、关节痛(39例,55.71%)、体重减轻(11例,15.71%)和发育不良(13例,18.57%)是最常见的症状。骨髓检查显示,29例患者(41.43%)有再生障碍性改变,20例患者(28.57%)有增生异常,21例患者(30%)细胞数量正常。14例患者(20%)有营养方面的原因,主要是巨幼细胞贫血,6例患有肿瘤性疾病的患者患有急性淋巴细胞白血病(ALL)。其他值得注意的病因包括溶血性贫血、细小病毒B19、粟粒性肺结核(TB)、再生障碍性贫血和系统性红斑狼疮。结论 该地区许多儿童全血细胞减少症病例是可以预防的。提高认识和采取适当的诊断策略对于这些疾病的早期识别和管理至关重要。

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Pancytopenia in children: etiological profile.儿童全血细胞减少症:病因学概况
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本文引用的文献

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Etiological causes of pancytopenia: A report of 137 cases.全血细胞减少症的病因:137例报告。
Avicenna J Med. 2016 Oct-Dec;6(4):109-112. doi: 10.4103/2231-0770.191447.
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Bone marrow evaluation in new-onset pancytopenia.骨髓评估新发性全血细胞减少症。
Hum Pathol. 2013 Jun;44(6):1154-64. doi: 10.1016/j.humpath.2012.10.006. Epub 2013 Jan 17.
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Pancytopenia in children: etiological profile.儿童全血细胞减少症:病因学概况
J Trop Pediatr. 2005 Aug;51(4):236-9. doi: 10.1093/tropej/fmi010. Epub 2005 Jul 13.

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