Evaluation of Pancytopenia in Adults

Abstract

Introduction: Pancytopenia, simultaneous presence of anemia, leucopenia and thrombocytopenia, is a commonclinical entity that we see in day to day practice Proper diagnostic evaluation requires detailed clinical history,physical examination and haematological assessment including careful peripheral blood smear examination andbone marrow evaluation.Materials and Methods: A total of 80 adult patients with pancytopenia/bicytopenia presenting between January2021 to January 2022 were included in the study. All patients underwent detailed clinical history and physicalexamination. Careful peripheral blood smear examination, CBC and bone marrow aspirate was done in all. Bonemarrow biopsy was done wherever feasible.Results: Megaloblastic anemia was the commonest cause of pancytopenia/bicytopenia making up 37.5% of allcases followed by erythroid hyperplasia (20%), aplastic anemia (10%). Haematological malignancies accounted for23.75% cases of the total. Bone marrow biopsy aided in the diagnosis of 8 cases (6 cases of aplastic anemia and twocases of dry tap) while in others it was concordant with aspiration findings.Conclusion: Bone marrow aspiration and biopsy are an important adjunct to peripheral smear examination forevaluation of cytopenias. Bone marrow trephine biopsy is helpful in cases of dry tap. We also conclude that thereis high prevalence of megaloblastic anemia due to nutritional deficiency among young population. Hence, this agerange should be the prime target for education regarding proper dietary habits, the remediation of which mightreduce the clinical burden of megaloblastic anemia.