Clinical, etiological and hematological profile of pancytopenic childern admitted in balchikitsalaya of RNT medical college, Udaipur Rajasthan

Abstract

To study the Clinical, Etiological and Hematological profile of Pancytopenic Children age group from 1 month to 18 years admitted in BalChikitsalay of MBGH, RNT Medical college, Udaipur.A Hospital based prospective study on children age group from 1month to 18 years admitted having pancytopenia and consenting for study were enrolled in study. Children who had received blood transfusion in previous 3 months, not consenting for study and known case of acute leukemia, aplastic anemia were excluded from study. Study was conducted in Balchikitsalay, MBGH, RNT Medical college, Udaipur, Rajasthan for a period of 1 year.42 children were enrolled in this study among this 22 were male and 20 were female. Most of the children presented with pallor (100%) fever (88%), bleeding manifestations (78.5%), pain abdomen (35.7%). On examination all these were anemic (100%), had splenomegaly(64.2%) ,hepatomegaly(59.5%) and bleeding manifestation in the form of hematemesis(21.4%) ,petechiae(26.1%) ,bleeding gums(21.4%) . Hematological findings in majority of children were anemia 4 to 7mg/dl, WBC count 2000to 4000/mm and Platelet count20,000 to 50,000/mm. Peripheral Blood smear revealed blast cells in 11patients, megaloblasts in 8 patients and malarial parasite in 3 children. Serum Vitamin B12 levels were <200 pg/ml in 20 children and <100 pg/ml in12 children. Bone marrow examination was performed in 36 children which revealed hypercellular marrow (28),normocellular marrow (5), hypocellular marrow(3). Most common cause of pancytopenia was vitamin B12 deficiency (40.4%). Other common causes were ALL (21.4%), Aplastic anemia (7.1%), Scrub typhus (7.1%), falciparum malaria (7.1%), CLD (7.1%), AML two patient Dengue & SLE one patient each.Vitamin B 12 deficiency is the commonest cause of pancytopenia, followed by ALL (21.4%) & Aplastic anemia (7.1%).