{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:25:17Z","timestamp":1787775917326,"version":"build-2784847793"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>Extrapulmonary tuberculosis (TB) is a well-recognized cause of pyrexia of unknown origin. However, clinical presentation of TB in children with isolated hematological abnormalities is extremely rare. Anemia, usually normocytic, normochromic, leukopenia, leukocytosis, thrombocytopenia, thrombocytosis, and monocytosis are more common complications of TB rather than pancytopenia. Only anecdotal case reports and small case series are available in this regard. We are reporting an 18-year-old boy who presented with on and off low-grade fever for 3 months and anorexia and progressive pallor for 1 month. After extensive workup, pancytopenia remained unexplained. Bone marrow (BM) examination revealed caseating granulomas, along with Mantoux positivity and contact with sputum-positive pulmonary TB. He responded favorably to antitubercular therapy (ATT) within 2 months. This report alerts clinicians to be vigilant regarding the rare possibility of BM TB while investigating unexplained pancytopenia, as it is completely reversible with ATT.<\/jats:p>","DOI":"10.4103\/abr.abr_170_20","type":"journal-article","created":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T04:55:11Z","timestamp":1608699311000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Pancytopenia without Hepatosplenomegaly: A Rare Manifestation of Extrapulmonary Tuberculosis in an Adolescent Boy"],"prefix":"10.4103","volume":"9","author":[{"given":"K Sushrith Kumar","family":"Yadav","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aman Kumar","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seba Ranjan","family":"Biswal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pragnya","family":"Panda","sequence":"additional","affiliation":[{"name":"Department of Medicine, SCB Medical College, Cuttack, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prateek Kumar","family":"Panda","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Neurology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indar Kumar","family":"Sharawat","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Neurology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,12,23]]},"reference":[{"key":"R1-20250805","first-page":"243","article-title":"Disseminated tuberculosis: Interesting hematological observations","volume":"58","author":"Avasthi","year":"2010","journal-title":"J Assoc Physicians India"},{"key":"R2-20250805","first-page":"86","article-title":"Evaluation of cases of pediatric extrapulmonary tuberculosis: A single center experience","volume":"54","author":"Kaba","year":"2019","journal-title":"Turk Pediatri Ars"},{"key":"R3-20250805","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.rmr.2010.02.005","article-title":"Pancytopenia in disseminated tuberculosis: Think of macrophage activation syndrome","volume":"27","author":"Le H\u00f4","year":"2010","journal-title":"Rev Mal Respir"},{"key":"R4-20250805","first-page":"485","article-title":"A clinical analysis of 20 cases with bone marrow granulomas","volume":"48","author":"Feng","year":"2009","journal-title":"Zhonghua Nei Ke Za Zhi"},{"key":"R5-20250805","first-page":"43","article-title":"Bone marrow granulomas: Clinicopathologic findings in 72 cases and review of the literature","volume":"2","author":"Bhargava","year":"1988","journal-title":"Hematol Pathol"},{"key":"R6-20250805","doi-asserted-by":"crossref","first-page":"353798","DOI":"10.1155\/2013\/353798","article-title":"Unusual manifestation of extrapulmonary tuberculosis","volume":"2013","author":"Alghamdi","year":"2013","journal-title":"Case Rep Med"},{"key":"R7-20250805","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s13256-018-1596-0","article-title":"Fever with pancytopenia: Unusual presentation of extrapulmonary tuberculosis: a case report","volume":"12","author":"Dalugama","year":"2018","journal-title":"J Med Case Rep"},{"key":"R8-20250805","first-page":"1041","article-title":"Tuberculosis of the bone marrow: Clinico-pathological study of 22 cases from Saudi Arabia","volume":"10","author":"Hakawi","year":"2006","journal-title":"Int J Tuberc Lung Dis"},{"key":"R9-20250805","first-page":"597","article-title":"Pancytopenia in disseminated tuberculosis","volume":"33","author":"Yadav","year":"1996","journal-title":"Indian Pediatr"}],"container-title":["Advanced Biomedical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/abr.abr_170_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:46:00Z","timestamp":1787773560000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/abr.abr_170_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.4103\/abr.abr_170_20","relation":{},"ISSN":["2277-9175"],"issn-type":[{"value":"2277-9175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]},"assertion":[{"value":"2020-07-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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