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Abstract
Introduction: La découverte d'une anomalie sanguine, d'une adénopathie, d'une masse médiastinale ou intraabdominale, ou d’une fièvre prolongée, peuvent conduire à inclure dans le diagnostic différentiel celui d'une hémopathie. L'examen de la moelle hématopoïétique devient alors une étape décisive du processus diagnostique. Deux techniques sont pratiquées : aspiration de moelle osseuse (AMO) et biopsie médullaire (BM). Objectifs: Identifier les principales indications de l’examen de la moelle osseuse (EMO) chez l’enfant à Brazzaville et répertorier les principales maladies retrouvées. Matériels et méthodes: Etude transversale rétrospective réalisée sur 10 ans (2006- 2015) dans les services d’hématologie clinique et biologique du CHU de Brazzaville. Elle a été faite sur la base de fiches. Ces dernières étaient remplies sur la base de registres. Avaient été exclus de cette enquête les EMO réalisés dans le cadre du suivi de maladie déjà connue. Résultats: 99 EMO dont 82 AMO et 17 BM ont été analysés. Ils avaient concerné 82 enfants ; la moyenne d’âge était de 9,86 ans [9 mois - 17 ans]. Le sex ratio Garçon/Fille était de 1,4. Les principales indications d’EMO étaient : bicytopénie/blastose sanguine (51,20%) et pancytopénie (36,60%). Les principales étiologies étaient : leucémie aigue (65,86%) et aplasie médullaire (17,07%). Conclusion : les anomalies de l’hémogramme sont les principales indications de l’EMO chez les enfants au CHU de Brazzaville. Elles sont le plus souvent dues à des urgences médicales.
ABSTRACT
Introduction: The discovery of a blood abnormality, lymphadenopathy, mediastinal or intra-abdominal mass, or prolonged fever can lead to inclusion of the cancers of blood in differential diagnosis . The review of the hematopoietic marrow becomes a decisive stage of the diagnostic process. Two techniques are used: bone marrow aspiration (BMA) and bone marrow biopsy (BMB). Objective: To describe the main indications of the examination of bone marrow (EBM) in children in Brazzaville and the associated diseases.
Materials and Methods: Retrospective cross-sectional study carried out over 10 years (2006- 2015) in clinical and biological hematology departments of University Hospital of Brazzaville. It was made on the basis of records. The EBM made in the follow-up of patients with known disease were excluded. Results: 99 EBM, among which 82 BMA and 17 BMB were analysed. They involved 82 children. The mean age was 9.86 years [9 months - 17 years]. The sex ratio Boy/Girl was 1.4. The main indications of EBM were: bicytopenia / blood blasts (51.20%) and pancytopenia (36.60%). The main associated diseases were: acute leukemia (65.86%) and aplastic anemia (17.07%). Conclusion: Abnormalities of blood counts are the main indications of the EBM in children at the University Hospital of Brazzaville. They are most often due to medical emergencies.
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References
- Moix PA, Favre L, Rosselet A, Monti M. Ponction biopsie médullaire. Rev Med Suisse. 2008;4:2337- 42.
- Fenneteau O, Lainey E. Valeur diagnostique du myélogramme au cours des pathologies constitutionnelles de l’enfant. Ann Biol Clin. 2007;65(5):483- 503.
- Githang'a JN, Dave P. Bone marrow examination at a paediatric hospital in Kenya. East Afr Med J.2001;78(7 Suppl):S37- 9.
- Sreedharanunni S, Sachdeva MU, Kumar N, Sharma P, Naseem S, Ahluwalia J et al. Spectrum of diseases diagnosed on bone marrow examination of 285 infants in a single tertiary care center. Hematology.2015;20(3):175- 81.
- Ali I, Hussain Mir Z, Amin Qureshi O, Kaiser A. Spectrum of bone marrow aspirations and their clinico-hematological profile in children. Int J Contemp Pediatr.2015;2(1):25- 28.
- Rahim F, Ahmad I, Islam S, Hussain M, Khan Khattak TA, Bano Q. Spectrum of hematological disorders in children observed in 424 consecutive bone marrow aspirations/biopsies. Pak J Med Sci.2005;21(4):433- 36.
- Naseem S, Varma N, Das R, Ahluwalia J, Sachdeva MU, Marwaha RK. Pediatric patients with bicytopenia/pancytopenia: review of etiologies and clinico-hematological profile at a tertiary center. Indian J Pathol Microbiol.2011;54(1):75- 80.
- Musa A, Wisam MA, AL-Saeed RM, AL-Hadad S. Bone Marrow Procedures in Children Welfare Teaching Hospital/Medical City Complex Indications and results. Fac Med Baghdad. 2014;56(3):254- 57.
- Jha A. Spectrum of hematological malignancies and peripheral cytopenias. J Nepal Health Res Counc.2013;11(25):273- 8.
- Zeb Jan A, Zahid B, Ahmad S, Gul Z. Pancytopenia in children: A 6-year spectrum of patients admitted to Pediatric Department of Rehman Medical Institute, Peshawar. Pak J Med Sci. 2013;29(5):1153- 57.
- Marchand T, Loschi M. Aplasies médullaires. Hématologie.2014;20:329- 341.
- Wu J, Cheng YF, Zhang LP, Liu GL, Lu AD, Jia YP et al. Clinical features and etiological spectrum in children with pancytopenia. Zhongguo Dang Dai Er Ke Za Zhi.2011;13(9):718-21.
- Gupta V, Tripathi S, Tilak V, Bhatia BD. A study of clinico-haematological profiles of pancytopenia in children. Trop Doct.2008;38(4):241- 3.
- Memon S, Shaikh S, Nizamani MA. Etiological spectrum of pancytopenia based on bone marrow examination in children. J Coll Physicians Surg Pak.2008;18(3):163- 7.
- Elira DA, Tchissambou N, Sangaré A. Etude épidémiologique et cliniques des aplasies médullaires sévères au Congo. Méd Afr Noire.1997;44(11):582- 90.
- Bhatnagar SK, Chandra J, Narayan S, Sharma S, Singh V, Dutta AK. Pancytopenia in children: etiological profile. J Trop Pediatr.2005;51(4):236- 9.
- Savage DG, Allen RH, Gangaidzo IT, Levy LM, Gwanzura C, Moyo A, et al. Pancytopenia in Zimbabwe. Am J Med Sci. 1999;317(1):22- 32.
- Mabiala Babela JR, Nika ER, Omani Etouolo NC, Moyen G. Malaria-related pancytopenia in children. Arch Pediatr. 2016;23(1):106- 7.
- Jignasha P, Vijay CP. Spectrum of haematological disorders observed in consecutive 150 cases on bone marrow examination. Int J Res Med.2014;3(2);139- 141
- Khan FS, Hasan RF. Bone marrow examination of pancytopenic children. J Pak Med Assoc. 2012;62(7):660- 3.
- Das Makheja K, Maheshwari BK, Suneel Kumar SA, Kumari S, Vikash. The common causes leading to pancytopenia in patients presenting to tertiary care hospital. Pak J Med Sci.2013; 29(5):1108– 1111.
- Stabler SP. Clinical practice. Vitamin B12 deficiency. N Engl J Med. 2013;368(2):149- 60.
References
Moix PA, Favre L, Rosselet A, Monti M. Ponction biopsie médullaire. Rev Med Suisse. 2008;4:2337- 42.
Fenneteau O, Lainey E. Valeur diagnostique du myélogramme au cours des pathologies constitutionnelles de l’enfant. Ann Biol Clin. 2007;65(5):483- 503.
Githang'a JN, Dave P. Bone marrow examination at a paediatric hospital in Kenya. East Afr Med J.2001;78(7 Suppl):S37- 9.
Sreedharanunni S, Sachdeva MU, Kumar N, Sharma P, Naseem S, Ahluwalia J et al. Spectrum of diseases diagnosed on bone marrow examination of 285 infants in a single tertiary care center. Hematology.2015;20(3):175- 81.
Ali I, Hussain Mir Z, Amin Qureshi O, Kaiser A. Spectrum of bone marrow aspirations and their clinico-hematological profile in children. Int J Contemp Pediatr.2015;2(1):25- 28.
Rahim F, Ahmad I, Islam S, Hussain M, Khan Khattak TA, Bano Q. Spectrum of hematological disorders in children observed in 424 consecutive bone marrow aspirations/biopsies. Pak J Med Sci.2005;21(4):433- 36.
Naseem S, Varma N, Das R, Ahluwalia J, Sachdeva MU, Marwaha RK. Pediatric patients with bicytopenia/pancytopenia: review of etiologies and clinico-hematological profile at a tertiary center. Indian J Pathol Microbiol.2011;54(1):75- 80.
Musa A, Wisam MA, AL-Saeed RM, AL-Hadad S. Bone Marrow Procedures in Children Welfare Teaching Hospital/Medical City Complex Indications and results. Fac Med Baghdad. 2014;56(3):254- 57.
Jha A. Spectrum of hematological malignancies and peripheral cytopenias. J Nepal Health Res Counc.2013;11(25):273- 8.
Zeb Jan A, Zahid B, Ahmad S, Gul Z. Pancytopenia in children: A 6-year spectrum of patients admitted to Pediatric Department of Rehman Medical Institute, Peshawar. Pak J Med Sci. 2013;29(5):1153- 57.
Marchand T, Loschi M. Aplasies médullaires. Hématologie.2014;20:329- 341.
Wu J, Cheng YF, Zhang LP, Liu GL, Lu AD, Jia YP et al. Clinical features and etiological spectrum in children with pancytopenia. Zhongguo Dang Dai Er Ke Za Zhi.2011;13(9):718-21.
Gupta V, Tripathi S, Tilak V, Bhatia BD. A study of clinico-haematological profiles of pancytopenia in children. Trop Doct.2008;38(4):241- 3.
Memon S, Shaikh S, Nizamani MA. Etiological spectrum of pancytopenia based on bone marrow examination in children. J Coll Physicians Surg Pak.2008;18(3):163- 7.
Elira DA, Tchissambou N, Sangaré A. Etude épidémiologique et cliniques des aplasies médullaires sévères au Congo. Méd Afr Noire.1997;44(11):582- 90.
Bhatnagar SK, Chandra J, Narayan S, Sharma S, Singh V, Dutta AK. Pancytopenia in children: etiological profile. J Trop Pediatr.2005;51(4):236- 9.
Savage DG, Allen RH, Gangaidzo IT, Levy LM, Gwanzura C, Moyo A, et al. Pancytopenia in Zimbabwe. Am J Med Sci. 1999;317(1):22- 32.
Mabiala Babela JR, Nika ER, Omani Etouolo NC, Moyen G. Malaria-related pancytopenia in children. Arch Pediatr. 2016;23(1):106- 7.
Jignasha P, Vijay CP. Spectrum of haematological disorders observed in consecutive 150 cases on bone marrow examination. Int J Res Med.2014;3(2);139- 141
Khan FS, Hasan RF. Bone marrow examination of pancytopenic children. J Pak Med Assoc. 2012;62(7):660- 3.
Das Makheja K, Maheshwari BK, Suneel Kumar SA, Kumari S, Vikash. The common causes leading to pancytopenia in patients presenting to tertiary care hospital. Pak J Med Sci.2013; 29(5):1108– 1111.
Stabler SP. Clinical practice. Vitamin B12 deficiency. N Engl J Med. 2013;368(2):149- 60.