Pancytopenia in children: A 6-year spectrum of patients admitted to Pediatric Department of Rehman Medical Institute, Peshawar

OBJECTIVE To determine the various spectrum of pancytopenia with its frequency on the basis of bone marrow examination in children from 6 months to 14 years. METHODS A retrospective descriptive study was carried out at Department of Pediatric Rehman Medical Institute Peshawar from January 2006 to December 2012. A total of 205 patient's age between 6 months and 14 years, fulfilling the inclusion and exclusion criteria were included in the study. Complete blood count, peripheral smear, bone marrow examination and Serum vitamin B12 level was done in all the cases. RESULTS Out of 14642 patients admitted to the Pediatric department during the study period, 205 (1.4%) patients were pancytopenic on their peripheral blood smear. Male outnumbered female with a ratio of 1.8:1. 42.5% of the patients were in the age group of 1 month to 5 years. Common etiological pattern identified were Aplastic anemia 58(28.3%), Hematological malignancies 49 (23.9%), megaloblastic anemia 40 (19.5%), idiopathic thrombocytopenic purpura 16 (7.8%), iron deficiency anemia 9 (4.4%), hemolytic anemia 7 (3.41%), Visceral leishmaniasis 6 (2.93%), hypersplenism 5 (2.44%), malaria 5 (2.44%), anemia of chronic disorder 4 (1.95%), Myelodisplastic syndrome 3 (1.46%), Niemen pick disease 2 (0.97%) and Gaucher disease in 1(0.49%). Common clinical presentations were fever, pallor, body aches, petechial hemorrhages and epistaxis. CONCLUSION Pancytopenia is one of the importance occurrences in pediatric patients. Acute leukemia and bone marrow failure are the most common causes yet megaloblastic anemia and infections are the treatable and reversible causes of pancytopenia.