Abstract
AIMS AND OBJECTIVES – To identify and analyse the most common hematological disorders diagnosed by doing bone marrow aspiration in pediatric patients.
MATERIAL AND METHOD – Bone marrow aspiration was done from Manubrium of the Sternum after injecting 2% xylocaine to the part in addition to sedation with diazepam. Bone marrow smears were prepared and stained with Leishman stain along with the simultaneous staining of the peripheral smears. A complete hemogram including Hb%, PCV, Red cell indices, platelet count, total leucocyte count and differential leucocyte count was also done by Automated cell counter. Finally, the bone marrow and peripheral smears were examined manually under oil immersion.
CONCLUSION - In this study it was found that the most frequently diagnosed hematological disorders on bone marrow aspiration in children are Anemias followed by Idiopathic Thrombocytopenic Purpura (ITP). Hematological disorders are more common in childhood period as compared to late adulthood. If taken individually then ITP cases outnumber the Anemia cases. Commonest leukemia in children is Acute Lymphoblastic Leukemia (ALL) and it follows the Anemias and ITP.
KEYWORDS: Bone Marrow Aspiration, Anemia, Leukemia, Idiopathic Thrombocytopenic Purpura
References
1. Ahmad Z, Durrani NU, Hazir T. Bone marrow examination in ITP in children : is it mandatory? J Coll Physicians Surg Pak. 2007 Jun; 17(6): 347-9.
2. Calpin C, Dick P ,Poon A, Feldman W. Is bone marrow aspiration needed in acute childhood idiopathic thrombocytopenic purpura to rule out leukemia? Arch pediatr Adolesc med. 1998 Apr; 152(4): 345-7.
3. Githang J.N. and Dave P. Bone marrow examination at a pediatric hospital in Kenya. East Africa Medical Journal Vol. 78 No. 7(supplement) July 2001.
4. Glaser K , Limarzi L and Poncher HG (1950). Cellular composition of the bone marrow in normal infants and children. Pediatrics, 6, 789-824.
5. Halperin DS, Doyle JJ. Is bone marrow examination justified in idiopathic thrombocytopenic purpura? Am J Dis Child. 1998 May ; 142(5): 508-11.
6. Idris M, Shah SH, Fareed J, Gul N. An experience with 60 cases of hematolo-gyical malignancies; a clinico haematolo-gical correlation. J Ayub Med Coll Abbottabad 2004 Oct-Dec; 16(4): 51-4.
7. Jubelirer SJ, Harpold R. The role of the bone marrow examination in the diagnosis of immune thrombocytopenic purpura: case series and literature review. Clin Appl Thromb Hemost. 2002 Jan ;8 (1):73-6.
8. Mercedes V, VDA. DE Torregrosa, Margarita Caceres De Costas. Megalo-blastic anemia of infancy. Clinical Pediatrics, Vol. 3, No. 6, 348-354 (1964).
9. Muhury Manas, Alka M Mathai, Sharada Rai, Ramadas Naik, Muktha R Pai, Ruchi Sinha. Megakaryocytic alterations in thrombocytopenia : A bone marrow aspiration study. Indian Journal of Pathology and Microbiology. Year : 2009, Vol: 52, Issue: 4, Page : 490-494.
10. Tariq Ayub and Fazal ur Rahman Khan. Prevalence of megaloblastic anemia in a pediatric unit. Gomal Journal of Medical Sciences ; January- June 2009, Vol. 7, No. 1:62-4.
11. Wong G C, Lee L H. A study of idiopathic thrombocytopenic purpura (ITP) patients over a ten year period. Ann Acad Med Singapore 1998; 27: 789-93.
Corresponding Author
Dr Aparajita Tomar
MBBS, MD, Pathology, Dept of Pathology
Bundelkhand Medical College, Sagar, Madhya Pradesh, India
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., Tel: 090396-32272 Fax: 07582-236270