Clinicoetiological Profile of Children with Bicytopenia and Pancytopenia

Background: Bicytopenia, and pancytopenia have a wide etiological spectrum in children, ranging from viral infections to malignancies. There is limited data describing the clinicoetiological profile of bicytopenia and pancytopenia in children in recent times. Methodology: Fifty children, aged 1 month to 12 years admitted with bicytopenia and pancytopenia were enrolled and evaluated. Basic patient information and clinical findings along with relevant investigations were obtained on a predesigned proforma and analyzed statistically. Results: Among the 50 cases studied, 46 had non-malignant causes, 24 (92.3%) cases had bicytopenia and 22 (91.66%) had pancytopenia. Among the 46 cases, 20 were infectious in origin. Sepsis was the commonest cause comprising 7 out of 20 cases (35%). Other causes included dengue fever, enteric fever, and malaria. The commonest cause of bicytopenia was nutritional anemia, observed in 8 out of 15 (53%) cases. The common causes of pancytopenia were megaloblastic anemia and aplastic anemia. Hematological parameters were significantly different among the bicytopenic and pancytopenic groups. MCH and MCHC were not significantly different between the groups. Hemoglobin and low white cell count were observed in aplastic anemia while thrombocytopenia was more marked in patients with megaloblastic anemia. A diagnosis of leukemia was made in 4 out of 50 cases, of which 2 each had pancytopenia and bicytopenia at presentation. Conclusion: The common causes of bicytopenia and pancytopenia were infections and nutritional deficiency. A history, examination and basic diagnostic tests were rewarding for the diagnosis in the majority.