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Clinical approach to pancytopenia in children

Isha Deshmukh

P ancytopenia is a common haematological condition often encountered in day to day clinical practice. It is defined as a decrease in all the three
cell lines of blood viz., red blood cells, leucocytes, and platelets. Many diseases affect production of these cells by bone marrow resulting into
pancytopenia i.e., simultaneous presence of anaemia, leucopoenia, and thrombocytopenia. Pancytopenia is defined as haemoglobin of < 9 gm/
dl, WBC < 4,000/cmm, and platelets < 100,000/cmm. Severe pancytopenia is defined as absolute neutrophil count < 500/cmm, platelet count <
20,000/cmm, and corrected reticulocyte count < 1%.
• Presenting symptoms of pancytopenia may be attributable to anaemia, leucopoenia, and/or thrombocytopenia. Anaemia may present with
fatigue, breathlessness, and cardiac symptoms. Neutropenia may present with febrile illness due to increased susceptibility to infections.
• Pancytopenia should be suspected on clinical grounds in any patient presenting with unexplained anaemia, prolonged fever and bleeding
tendency. The severity of pancytopenia and underlying aetiology determine the management and prognosis.
• With the above background we hereby discuss the clinical approach to pancytopenia in pediatric population and the various diseases pre-
senting as pancytopenia

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