Pancytopenia

Abstract

Introduction: Pancytopenia is said to exist in an adult when the hemoglobin level is less than 13.5gm/dl in males and 1 l.5gm/dlin females, white cell count less than 4xl09IL and platelet count less than 150x109/L1. The causes of pancytopenia are aplastic anemia, subleukemicleukemia, myelodysplasia2 multiple myeloma, nutritional deficiencies leading to megaloblastic anemia, hypersplenism, paroxysmalnocturnal hemoglobinuria, AIDS, infections such as miliary tuberculosis, leishmaniasis, brucellosis etc. Objectives: To determine the frequencyof various causes of pancytopenia in gender at Chandka Medical College, Larkana. Study design: Cross Sectional Study. Setting: OPD &Medical Ward-ll, Chandka Medical College Hospital Larkana. Duration with dates: 01 years study from February 2007 to February 2008.Subject and methods: Patients of either sex, who attended medical ward-ll of Chandka Medical College Hospital Larkana, either as inpatientor out patient department, from February 2007 to February 2008 and fulfilled the inclusion criteria, were included in this study. Pancytopeniawas considered as hemoglobin value less than 13.5gm/dl in males or 11.5gm/dl in females, a white cell count less than 4x109/L and Plateletscount less than 150x109/L. Patients of less than 12 years and pregnant females were excluded from the study. Result: Out of 40 patients, 29(72.5%) were males and 11 (27.5%) were females. Female to male ratio was 1:2.6. The mean ages of males were 29.10 ± 16.46 years whereasof females 36.14 ± 15.6 years (P = 0.22). Aplastic anemia was the most common pathology encountered and was diagnosed in 13 cases(31.5%), followed by hypersplenism 09 (22.9%), Megaloblastic anemia 06 (15%) and hodgkin's lymphoma in 04 (10%) cases. Other lesscommon causes detected were multiple myeloma 02 (5%), drug induced 02 (5%) and malaria, milliary tuberculosis, myelodysplastic syndrome,hemophagocytic syndrome was 01 (2.5%) case in each. Conclusion: We concluded that aplastic anemia was the most common cause in ourpatients and more than 2/3rd patients were young males. We think the causes of aplastic anemia in this study may be misuse of drugs, kushtas,exposure to chemicals and viral infections.