Bone marrow examination: A useful aid in early diagnosis of PUO in children

Abstract

Background: Pyrexia of unknown origin (PUO) is a common diagnostic dilemma that needs a number of diagnostic modalities to arrive at a diagnosis. Bone marrow examination is one of the common tests implicated in the diagnosis in combination with others. Authors, in this study, have attempted to explore the role of bone marrow morphological study in determining the various causes of PUO in children. Materials and Methods: A retrospective study was conducted at Dr. B. C. Roy PGIPS, Kolkata, West Bengal over the period of 2 years. Bone marrow aspiration was performed and evaluated morphologically in 100 patients. Marrow trephine biopsy was also performed in some cases, undiagnosed in aspiration smears, to reach at a conclusion. Results: Besides reactive hyperplasia (25%), other frequent outcomes were acute lymphoblastic leukemia in 15 (15%), marked hemophagocytosis in 15 (15%), and visceral leishmaniasis in 5 (5%) patients. Conclusion: Early diagnosis of PUO can be aided by the morphologic examination of bone marrow. Bone marrow biopsy is a complementary and in some respects, better diagnostic tool than aspiration in patients with PUO. This study will help to know the current spectrum of diseases causing PUO in children in this region.

Keywords

• bone marrow examination
• hematological
• malignancy
• pyrexia of unknown origin