Etiological Evaluation in 120 Cases of Pancytopenia by Bone Marrow Examination

Abstract

BACKGROUND:Pancytopenia is a relatively common hematological entity resulting from a variety of disease processes. The present study is carried out to find out the causes of pancytopenia by bone marrow examination. MATERIALS AND METHODS: Bone marrow examination is carried out in 120 cases of pancytopenia over a period of 3 years. Age of patients ranged from 2 to 75 years with a mean of 32 years. Most of the patients presented with generalized weakness and fever. Commonest physical finding was pallor followed by splenomegaly. Dimorphic anemia was the predominant blood picture. The commonest marrow finding was megaloblastic erythroid hyperplasia. The commonest cause of pancytopenia was megaloblastic anemia (58.3%) followed by aplastic anemia (18.3%). Others include acute leukemia, myelodysplasia, non-Hodgkin's lymphoma and disseminated tuberculosis. CONCLUSION: The present study shows the importance of bone marrow examination in evaluating pancytopenia and the geographical variation in the etiology as megaloblastic anemia is the predominant cause of pancytopenia in Indian subcontinent. KEYWORDS: pancytopenia, bone marrow, megaloblastic anemia, aplastic anemia. INTRODUCTION:Pancytopenia is a disorder in which all three major formed elements of blood (red blood cells, white blood cells and platelets) are decreased than normal. It is a relatively common clinicohaematological entity encountered in our day-to-day clinical practice. Manifestations of peripheral pancytopenia are due to a wide variety of disorders which primarily or secondarily affect the bone marrow. [1] The presenting symptoms are usually attributable to anemia, thrombocytopenia and leucopenia. The severity of pancytopenia and the underlying pathology determine the management and prognosis of the patients. The present study has been undertaken to evaluate the various causes of pancytopenia by bone marrow examination.