Pancytopenia in Children: Etiological Profile in North India

To determine the etiological profile of pancytopenia in pediatric patients.

Medical records review of a 33-month period (2007 to 2009) was done at a tertiary-care hospital in Greater Noida, UP. Clinical and hematological data of all patients with pancytopenia (Hb<10g/dL, total leucocyte count < 4X10⁹d/L, platelet count <150X10⁹/L) at presentation was analyzed. Patients on cytotoxic chemotherapy, those developing pancytopenia during hospital stay, patients referred from other centers with diagnosed hematological malignancies, and neonates were excluded.

Forty-two children (mean age 8.26 years, range 8.5 mo-13 year, M:F::1:0.8) were included. Megaloblastic anemia, aplastic anemia and infections were the commonest causes, being responsible for 23.8%,14.3% and 45.2% of the cases, respectively. Bone-marrow aspiration (BMA) was helpful in reaching a definitive diagnosis in 86% of those in whom sufficient marrow tissue was retrieved for analysis. Aplastic anemia was the commonest reason for failure of BMA in providing a diagnosis.

Majority (69%) of the causes of pancytopenia among pediatric patients in this region are easily treatable. There is a need to be aware of such conditions and appropriate investigative modalities should be undertaken for the same.