RESUMEN
Background: The etiology of bicytopenia/pancytopenia varies widely in children, ranging from transient marrow viral suppression to marrow infiltration by fatal malignancy. Depending on the etiology, the clinical presentation can be with fever, pallor or infection. Knowing the exact etiology is important for specific treatment and prognostication. Aims: To evaluate the etiological and clinico-hematological profile in children with bicytopenia and pancytopenia. Materials and Methods: A review of bicytopenic and pancytopenic children referred for bone marrow examination from January 2007 to December 2008 was done. Detailed history, clinical examination and hematological parameters at presentation were recorded. Results and Conclusion: During the study period, a total of 990 children were referred for bone marrow examination for different indications. Of these, 571 (57.7%) had either pancytopenia (17.7%) or bicytopenia (40%). Commonest form of bicytopenia was anemia and thrombocytopenia seen in 77.5% cases, followed by anemia and leukopenia in 17.3% and leukopenia and thrombocytopenia in 5.5% cases. Most common etiology was acute leukemia (66.9%) in bicytopenic children and aplastic anemia (33.8%) in pancytopenic children. Children with bicytopenia had a higher incidence of underlying malignancy (69.5% vs. 26.6%), splenomegaly (60.5% vs. 37.4%), lymphadenopathy (41.8% vs. 15.1%) and circulating blasts (64.6% vs. 20.1%) and a lower incidence of bleeding manifestations (12.1% vs. 26.6%) as compared to children with pancytopenia.
Asunto(s)
Anemia/epidemiología , Anemia/etiología , Médula Ósea/patología , Niño , Preescolar , Femenino , Enfermedades Hematológicas/etiología , Enfermedades Hematológicas/patología , Humanos , Lactante , Recién Nacido , Leucopenia/epidemiología , Leucopenia/etiología , Masculino , Pancitopenia/epidemiología , Pancitopenia/etiología , Prevalencia , Centros de Atención Terciaria , Trombocitopenia/epidemiología , Trombocitopenia/etiologíaRESUMEN
Se estudia la incidencia de citopenias en 42 pacientes con infección por el Virus de Inmunodeficiencia Humana (HIV), según sus características clínicas y epidemiológicas. La trombocitopenia fue la característica hematológica de mayor incidencia en el estadio de infección asintomática. La asociación de trombocitopenia-linfopenia comenzó a instaurarse en el estadio de Linfadenopatía Generalizada Persistente (LGP). Hubo una incidencia progresiva de neutropenia y anemia desde el estadio de LGP al Síndrome de Inmunodeficiencia Adquirida (SIDA), el que se caracterizó, además, por marcada linfopenia y trombocitopenia. Sólo en el SIDA se observó pancitopenia. La incidencia similar de citopenias en los grupos estudiados sugiere que su presencia es independiente al grupo en riesgo a que pertenecen los individuos HIV-seropositivos.