Role of basic haematological investigations in the evaluation of pancytopenia

Abstract

Introduction: Pancytopenia is a caused by single or different co-existing pathology. As the management and prognosis depends on underlying pathology, identification of correct aetiology is crucial. Aims: The current study intends to study the etiological profile of Pancytopenia and to identify the CBC, peripheral smear findings which are helpful in planning the additional investigations to arrive at a specific diagnosis. Materials and Methods: It is a retrospective descriptive study conducted in a tertiary care centre in Kerala.132 Cases of Bone marrow aspirates with the indication of pancytopenia, received from January 2011 to June 2012 were analyzed. The etiological profile was studied. The clinical features, Hemoglobin, Total Leukocyte count, Platelet count and Peripheral smear findings were evaluated in detail. Results: The most common cause of Pancytopenia in the present study is Sub leukemic leukemia (23.5%) followed by Hypersplenism (17.4%) and Megaloblastic Anemia (14.3%). Age range was from 12 to 88 years and Males and Females were almost equal in distribution. Hepatomegaly, Splenomegaly were seen in 19% and 28% cases respectively. Lowest median Hemoglobin value was observed in Megaloblastic Anemia whereas Leucopenia and Thrombocytopenia were most severe in Hypoplastic Anemia. Anisopoikilocytosis, Polychromasia, circulating normoblasts and Hypersegmented neutrophils were predominant in Megaloblastic Anemia. Relative Lymphocytosis was predominant in Hypoplastic anemia whereas Immature WBCs were seen commonly in acute leukemia. Conclusion: This study highlights the importance of the primary haematological investigations, which are helpful in narrowing down the differential diagnosis and to plan the further investigations to arrive at a definite diagnosis. Keywords: Complete blood count, Peripheral smear, Bone marrow, Sub- acute leukaemia, Megaloblastic anaemia.