Abstract
Background : Pancytopenia is a common hematological finding resulting from various diseases which requires thorough clinical history, physical examination and blood investigations so as to evaluate the cause and plan the management of pancytopenic patients. The aim of this study is to determine the incidence, various causes, common clinical presentations of pancytopenia and to correlate hematological parameters with clinical findings in differentiating causes of pancytopenia. Methods : A two year prospective study which included patients of age 15 years and above having pancytopenia on blood film examination ( Hb < 10g/dl, TLC < 4000/cmm and platelets < 1lakh/ cmm). Total 226 cases of pancytopenia were evaluated clinically along with hematological parameters and bone marrow aspiration in Central Laboratory of Department of Pathology, Tertiary care hospital, Navi Mumbai. Results : The most common causes of pancytopenia were malaria (50%), megaloblastic anemia (18.6%) and dengue (18.1%) followed by hypersplenism (7.1%) and iron deficiency anemia. The other uncommon causes were septicemia (2.2%), AIDS (1.8%), tuberculosis (1.8%), aplastic anemia (1.3%), leptospirosis (0.9%), dimorphic anemia (0.9%), dyskeratosis congenita (0.4%) and myelodysplastic syndrome (0.4%). The age of the patients ranged from 15-85 years with male preponderance. The most common clinical features were weakness (80%), fever (72.1%), pallor (100%) and hepatomegaly (62.8%). Normocytic normochromic was the predominant blood picture. Conclusion : The present study concludes that detailed primary hematological investigations and other supportive biochemical investigations can be helpful to rule out or to diagnose causes of pancytopenia and invasive procedures like bone marrow aspiration or biopsy can be avoided in majority of cases. DOI:10.21276/APALM.1519
Highlights
IntroductionPancytopenia is a disorder in which all three major formed elements of blood (red blood cells, white blood cells and platelets) are decreased than normal
Pancytopenia is a disorder in which all three major formed elements of blood are decreased than normal
Studies done in India stress the importance of megaloblastic anemia followed by aplastic anemia as being the major causes of pancytopenia.[2],[3]
Summary
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 common clinical problem with an extensive differential diagnosis. [1] Thorough physical examination, clinical history and peripheral blood picture can provide valuable information in diagnosing pancytopenia. Studies done in India stress the importance of megaloblastic anemia followed by aplastic anemia as being the major causes of pancytopenia.[2],[3]. Pancytopenia is a common hematological finding resulting from various diseases which requires thorough clinical history, physical examination and blood investigations so as to evaluate the cause and plan the management of pancytopenic patients. The aim of this study is to determine the incidence, various causes, common clinical presentations of pancytopenia and to correlate hematological parameters with clinical findings in differentiating causes of pancytopenia
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