# Reversible Pancytopenia Due to Severe Iron Deficiency Anemia in a 12-Year-Old Girl

## TL;DR

A 12-year-old girl with severe iron deficiency anemia showed reversible pancytopenia, which improved with iron supplementation and dietary changes.

## Contribution

This case report demonstrates that severe iron deficiency can lead to pancytopenia in children, a rare but reversible condition.

## Key findings

- The patient showed complete recovery after six months of iron supplementation and dietary changes.
- Severe iron deficiency was confirmed by profoundly low ferritin levels and microcytic hypochromic red cells.

## Abstract

Iron deficiency anemia remains a global health challenge among young children starting from birth. Pancytopenia is a rare presentation of iron deficiency in children, being highly reversible with a simple treatment strategy including diet modification and iron supplementation.

A 12-year-old Omani girl presented with a four-week history of fatigue, dizziness, and palpitations. Investigations revealed hemoglobin of 3.3 g/dL (11-14.5 g/dL), platelet of 47×109/L (150-450×109/L), white cell count of 3.9×109/L (2.4-9.5×109/L), and absolute neutrophil count of 0.5×109/L (1-4.8×109/L). Her red blood cell distribution width was high (34.1%; 11.5-16.5%), and her reticulocytes were normal (2.1%; 0.2-2%) with a mild elevation in the immature reticulocytes. Moreover, the ferritin level was profoundly low with a result of 1 ug/L only. Her peripheral blood smear showed pancytopenia in a background of microcytic and hypochromic red cells. After appropriate supplementation with oral ferrous sulfate in combination with an iron-rich diet, she showed complete recovery after six months from the initiation of management.

This case report highlights that iron deficiency can be a cause of severe pancytopenia in children.