SPECTRUM OF HEMATOLOGICAL DISEASES IN PEDIATRIC PATIENTS PRESENTING WITH ANEMIA BASED ON BONE MARROW EXAMINATION

Background: This study was conducted to identify the different acquired causes of anemia on the basis of bone marrow examination in children admitted to the pediatric Unit of Rehman Medical Institute Peshawar. Material Methods: It was a retrospective descriptive study conducted at Pediatric Department of Rehman Medical Institute Peshawar on data of 5 years from 1stJanuary, 2008 to 31stDecember, 2012. A total of 249 cases were included in the study that presented with anemia. Patients with hereditary blood disorders and recent history of blood transfusion were excluded from the study. They were assessed clinically by general physical and systemic examination. Complete blood count, peripheral smear and bone marrow examination was performed in all cases. Results: During the study period 14,642 patients were admitted, 249(1.7%) cases presented with hematological disorders on the basis of bone marrow examination. In the etiological pattern, aplastic anemia 71(28.51%) was the most common etiology followed by leukemia 59(23.69%), megaloblastic anemia in 48(19.27%), other less common problems like idiopathic thrombocytopenic purpura 19(7.63%), iron deficiency anemia 9(3.61%), visceral leishmaniasis 8(3.21%), anemia of chronic disorder 6(2.41%) and malaria in 6(2.41%) cases. Common clinical presentations were fever, pallor, body aches, petechial hemorrhages and epistaxis. Conclusion: Anemia secondary to acquired causes is a disorder with serious consequences. Bone marrow examination is helpful in the diagnosis of most of these cases