Caracterización clínica y etiológica de la pancitopenia en población pediátrica en pacientes atendidos en el Hospital del Niño Dr. Francisco De Icaza Bustamante, período 2020 - 2024.

Abstract

Introduction: Pancytopenia is a hematological finding characterized by a simultaneous decrease in the three peripheral blood cell lines. In pediatric patients, it may occur as a manifestation of both hematological and non-hematological diseases; therefore, identifying its etiology is essential to guide the diagnostic approach, treatment, and prognosis. Objective: To determine the association between the etiology of pancytopenia and clinical characteristics, hematological findings, and clinical outcomes in pediatric patients treated at Hospital del Niño Dr. Francisco de Icaza Bustamante during the 2020–2024 period. Methods: An observational, retrospective, cross-sectional, descriptive-analytical study was conducted. A total of 53 pediatric patients with pancytopenia who met the selection criteria were included. Demographic, clinical, hematological, etiological, and outcome variables were analyzed. Inferential statistical tests were applied according to the nature and distribution of the variables, considering p<0.05 as statistically significant. Results: The median age was 6 years (IQR: 2–10), and 58.5% of the patients were male. The most frequent clinical manifestations were pallor (96.2%), fever (69.8%), ecchymosis or hematomas (60.4%), and petechiae or purpura (58.5%). Bone marrow aplasia was the most frequent etiology (49.1%). Statistically significant differences among etiological groups were observed for headache (p=0.007), fever (p=0.027), hyporexia (p=0.038), jaundice (p=0.024), petechiae or purpura (p=0.042), and ecchymosis or hematomas (p=0.038). Among hematological parameters, platelet count showed significant differences according to etiology (p=0.008). A statistically significant association was also found between etiology and final clinical outcome (p=0.003). Conclusion: Bone marrow aplasia was the most frequent etiology of pancytopenia in the study population. Etiological groups showed significant differences in specific clinical manifestations and platelet count. In addition, etiology was significantly associated with final clinical outcome, highlighting its relevance to the clinical characterization and disease course of pediatric patients with pancytopenia.