Spectrum of Hematological Disorders in Pediatrics

July 22, 2022 updated by: Zakria Younes Mohammed Essemy, Assiut University

A Spectrum of Hematological Disorders in Children Presented With Pancytopenia at Assiut University Hospital

To determine the spectrum of pancytopenia with its frequency and etiology in children presenting to Assiut University Children Hospital during one year

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Pancytopenia is a condition in which there is a decrease of all the three cellular elements of blood, namely erythrocytes, leukocytes, and platelets . It is quite a common finding among children. According to regional studies, it makes up around 2.90% to 3.57% of the burden of presentations in the pediatric population. Some of the presenting symptoms include, but are not limited to, pallor, fever, weight loss, dyspnea, bleeding, bruising, visceromegaly, and increased risk of infections .

Pancytopenia is not a disease in itself but a laboratory finding of the constitution of diseases. It can occur due to a variety of disorders which can be as simple as nutritional deficiencies to serious malignant disorders . Megaloblastic anemia and acute lymphoblastic leukemia are among the most common presentations of pancytopenia.

Pancytopenia results in a hypoplastic bone marrow. It is diagnosed on the basis of the complete blood count test. Pancytopenia is labeled when the hemoglobin (hb) is less than 10 gm%, absolute neutrophil count (anc) is less than 1.5*109/l, and platelet count is less than 100*109/l [9].

But, in order to find out the etiological factor causing pancytopenia, bone marrowexamination is done. Being an interventional procedure, it is relatively safe with little or no risk of bleeding.

Etiology of pancytopenia The etiology of pancytopenia can be broadly categorized as a central type that involves disorders of production or a peripheral type that involves disorders of increased destruction.These causes could contribute to the pancytopenia independently or as a combination.

Decreased production (central type): Pancytopenia due to decreased production is mostly secondary to nutritional deficiencies. Pancytopenia caused by bone marrow failure is known as aplastic anemia. Aplastic anemia could be idiopathic/autoimmune, secondary to infections (such as parvovirus B19, hepatitis, human immunodeficiency virus (HIV), cytomegalovirus, or Epstein-Barr virus), after drug toxicity, or chemotherapeutic agents (methotrexate, dapsone, carbimazole, carbamazepine, chloramphenicol). Pancytopenia can also be related to inadequate intake (as seen in eating disorders and alcoholics) or malabsorption.The production of cell lines is also impaired when the bone marrow is infiltrated by malignancies (lymphoma, leukemia, multiple myeloma) or granulomatous disorders. Metastatic tumors can also cause bone marrow replacement late in the disease, thus producing pancytopenia.

Increased destruction (peripheral type): Peripheral destruction of cells can be associated with many autoimmune conditions (such as systemic lupus erythematosus, rheumatoid arthritis) and splenic sequestration (alcoholic liver cirrhosis, HIV, tuberculosis, malaria). Hypersplenism affects more frequently the platelets and erythrocytes than leukocytes.

Differential diagnosis Multiple conditions can present with pancytopenia; hence, when someone shows with pancytopenia, a complete evaluation is performed to detect the cause of pancytopenia. Bone marrow disorders such as aplastic anemia, myelodysplastic syndrome, acute leukemia, myelofibrosis, megaloblastic anemia, paroxysmal nocturnal hemoglobinuria, and Fanconi's anemia can present with pancytopenia. Fanconi anemia is the most common congenital cause of bone marrow failure with an autosomal recessive inheritance pattern. In myelofibrosis, there is a replacement of the bone marrow cells with fibrotic tissue. Malignancies such as lymphoma, multiple myeloma, and hairy cell leukemia can also present with pancytopenia. Non-bone marrow conditions present with pancytopenia include systemic lupus erythematosus, infections (such as parvovirus B19, Epstein Barr virus, HIV, hepatitis, leishmaniasis, tuberculosis, malaria, and histoplasmosis).

Study Type

Observational

Enrollment (Anticipated)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

4 weeks to 18 years (ADULT, CHILD)

Accepts Healthy Volunteers

N/A

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

patients with pancytopenia from the age of one month to 18 years old

Description

Inclusion Criteria:

  • All patients with presistant pancytopenia from age 1 month to 18 years at Assiut university hospital of pediatrics

Exclusion Criteria:

  • Patients below age of 1 month or above 18 years

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
percentage of aplastic anemia among other causes of pancytopenia in childern presented to assiut university childern hospital with abnormal CBC
Time Frame: one year
getting a proper diagnosis of different cases of pancytopeina in childern which helps in their treatment
one year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ANTICIPATED)

September 1, 2022

Primary Completion (ANTICIPATED)

September 30, 2023

Study Completion (ANTICIPATED)

November 1, 2023

Study Registration Dates

First Submitted

July 19, 2022

First Submitted That Met QC Criteria

July 22, 2022

First Posted (ACTUAL)

July 26, 2022

Study Record Updates

Last Update Posted (ACTUAL)

July 26, 2022

Last Update Submitted That Met QC Criteria

July 22, 2022

Last Verified

July 1, 2022

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • pancytopenia in pediatrics

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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Locations

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