Pancytopenia: A Clinico Hematological Study

Abstract

Background:Pancytopenia is a relatively common hematological entity. It is a striking feature of many serious and life-threatening illnesses, ranging from simple drug-induced bone marrow hypoplasia, megaloblastic anemia to fatal bone marrow aplasias and leukemias. The severity of pancytopenia and the underlying pathology determine the management and prognosis. Thus, identification of the correct cause will help in implementing appropriate therapy.Objectives:To study the clinical presentations in pancytopenia due to various causes; and to evaluate hematological parameters, including bone marrow aspiration.Materials and Methods:It was a prospective study, and 104 pancytopenic patients were evaluated clinically, along with hematological parameters and bone marrow aspiration in Hematology Unit, Department of Pathology, JJMMC, Davanagere, during the period of September 2005 to September 2007.Results:Among 104 cases studied, age of patients ranged from 2 to 80 years with a mean age of 41 years, and male predominance. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. Dimorphic anemia was the predominant blood picture. Bone marrow aspiration was conclusive in all cases. The commonest marrow finding was hypercellularity with megaloblastic erythropoiesis. The commonest cause for pancytopenia was megaloblastic anemia (74.04%), followed by aplastic anemia (18.26%).Conclusion:Thepresent study concludes that detailed primary hematological investigations along with bone marrow aspiration in cytopenic patients are helpful for understanding disease process and to diagnose or to rule out the causes of cytopenia. These are also helpful in planning further investigations and management.

Etiological profile of pancytopenia in a tertiary care hospital

“…12 But recent study by Gayatri et al reported 51.35%. 13 Khunger JM et al demonstrated no neutrophils in megaloblastic anemia. 8 This variation could be due to subjective variation in analysis of peripheral smear.…”

Hematologic Analysis of Pancytopenia and Correlation with Bone Marrow Findings: Study in a Tertiary Care Centre

“…Similarly, Tilak et al [6]in their study conducted in 1999 found that the most common cause of pancytopenia was megaloblastic anaemia (68%) with aplastic anaemia being second most common cause (7.7%). Megaloblastic anaemia was found to be main cause of pancytopenia in the studies of Gayatri et al [12] , Deepak kumar et al [13] in 74%…”

“…The highest incidence by age, 33 (0.15%) cases, is seen in the age group of 40-60 years, which is slightly higher than incidence (29.4%) for the age group of 15-30 years in the studied conducted by Pathak et al [10] ( Table 2) and15-35 years with an incidence of 43% in studies conducted by Sweta et al [11] . The highest incidence (29.04%) by age according to a study by Gayatri and Rao et a [12] is noted in the age group of 2-18 years. The highest age incidence of pancytopenia in the current study is nearly similar to the findings of Deepak Kumar et al [13] which is 30-49 years.…”

The Aetiological Spectrum of Pancytopenia – A Three Year Clinico-Hematological Study.

“…Megaloblastic anemia was the most common cause of pancytopenia (48.9%) in our study which is comparable to other studies. [4,6,7] The high prevalence of nutritional anemia in India has been cited for the increased frequency of megaloblastic anemia.Vitamin B12 deficiency was more common than folate deficiency in our study. Among the nutritional anemias, vitamin B 12 deficiency is more prevalent than folate deficiency as reported by authors in their study from Pakistan.…”

“…[8] Incidence of hypoplastic anemia/ aplastic anemia varies from 7% to 30% among pancytopenia patients [3,4,5,6,7 ] . In our study it was 15.2% which was comparable to Khodke K et al [6] and Khunger JM et al [1] .…”