Pancytopenia: A multidisciplinary assessment of hemato-etiological and clinical spectrum in a tertiary care hospital

Abstract

Background:The causes of pancytopenia range from simp le, co mp letely treatable diseases to serious life-threatening conditions. A thorough evaluation of these cases is mandatory as it would benefit the patients to receive appropriate treatment. Objecti ves: Evaluation of etio-hematological and clin ical spectrum of pancytopenia. Settings and Design: A prospective study of two years (Jan 2016 -December 2017) was conducted on pancytopenic patients, attending Navodaya Medical Co llege, Hospital and Research Centre, Raichur, Karnataka. Material and Methods: Etio-hematological and clin ical evaluation was done considering the relevant biochemical and serological investigations. Results: A total number of 1368 of cases were diagnosed as pancytopenia. The patients' age ranged from 19 to 68 years and M: F ratio was 2.1:1. Most frequent clinical symptom was generalized weakness (90%) and least was bony pain (2%). Peripheral smear examination revealed predominantly macrocytic blood picture (47.9%). Bone marrow aspiration was performed in 444 cases (32.4%), among which Megaloblastic anaemia (Exclusive and Co mb ined with iron deficiency anemia) was the commonest (52.7%). Et iologies of pancytopenia in decreasing order of frequency included Megaloblastic anemia {935 cases (68.4%) -Exclusive type (713 cases; 52.2%) and Combined with iron deficiency anemia (222 cases;16.2%)z, followed by Dengue fever (141 cases;10.3%), Hypoplastic/Aplastic anemia [106 cases;7.8% (Drug induced -4 cases; 0.2%)], Septicemia (60 cases;4.5%), Leukemia (46 cases;3.25%), Ch ronic malaria (46 cases ;3.25%) and Myelodysplastic syndrome (34 cases; 2.5%). Conclusion: Keeping in mind varied et iologies of pancytopenia, thorough diagnostic evaluation is required to achieve better clinical outcome.