Abstract
Background: Pancytopenia is diagnosed when there is a reduction in all three hematopoietic cell lines. Till date there is limited number of studies on the frequency of various causes of pancytopenia. Of these some have been reported from the Indian subcontinent. There appears to be a changing spectrum of pancytopenia over the past two decades. The objective was to study the etiopathological spectrum of adult patients with pancytopenia over a period of one and half year.
 Methods: The Prospective and retrospective observational study was conducted in the Department of Family Medicine, Batra Hospital and Medical Research Centre, New Delhi. A total of 120 Patients were included in the study. All patients gave their consent to take part in the study and were subjected to a questionnaire regarding symptoms, past relevant history, lifestyle and detailed clinical examination and investigations as mentioned in materials and methods.
 Results: Six broad diagnostic groups could be identified in adults with pancytopenia. Megaloblastic anemia (D1) was the largest group comprising 57.5% of all patients. 11.7% of patients with pancytopenia were diagnosed as Aplastic anemia (D2).11.7% of patients with pancytopenia were diagnosed as leukemia/lymphoma (D3) such as lymphoma (1), metastatic anaplastic carcinoma (1), acute leukemia (11), and metastatic gastric carcinoma (1). 15% of patients with pancytopenia were diagnosed with infections (D4) such as complicated malaria cases (7), HIV (5), disseminated tuberculosis (4), viral (2). We also encountered (D5) 0.8% was Myelophthisis/Storage disorder as myelodysplastic syndrome (1) and 3.3% were other (D6) as reactive marrow (4).
 Conclusion: Pancytopenia is not a disease itself. It is a hematological feature of varying etiology with slight male preponderance. Megaloblastic anemia along with mixed nutritional anemia is leading cause of pancytopenia in India followed by infections being second and aplastic anemia and acute leukemia being third common causes.
 Keyword: Pancytopenia, Megaloblastic anemia, Nutritional anemia.
Highlights
Pancytopenia is diagnosed when there is a reduction in all three hematopoietic cell lines.[1]
Megaloblastic anemia (D1) was the largest group comprising 57.5% of all patients. 11.7% of patients with pancytopenia were diagnosed as Aplastic anemia (D2).11.7% of patients with pancytopenia were diagnosed as leukemia/lymphoma (D3) such as lymphoma (1), metastatic anaplastic carcinoma (1), acute leukemia (11), and metastatic gastric carcinoma (1). 15% of patients with pancytopenia were diagnosed with infections (D4) such as complicated malaria cases (7), HIV (5), disseminated tuberculosis (4), viral (2)
Pancytopenia is not a disease itself. It is a hematological feature of varying etiology with slight male preponderance
Summary
Pancytopenia is diagnosed when there is a reduction in all three hematopoietic cell lines.[1]. Till date there is limited number of studies on the frequency of various causes of pancytopenia Of these some have been reported from the Indian subcontinent. Studies done in India recently revealed megaloblastic anemia/aplastic anemia, leukemia, leishmaniasis, myelodysplastic syndrome, paroxysmal nocturnal hemoglobinuria, overwhelming viral infections (HIV, viral hepatitis etc.) and drug induced pancytopenia as the most commonly diagnosed causes of pancytopenia.[5,6] The incidence of aplastic anemia quoted from the west is 10.25%. Of particular interest are studies regarding megaloblastic anemias in India which show an increasing prevalence of this disease as a proportion of all anemias / pancytopenia. Keeping these factors in mind we plan to review the clinical and. The hypothesis of this thesis is “TO STUDY THE ETIOPATHOLOGICAL SPECTRUM OF ADULT PATIENTS WITH PANCYTOPENIA’’ in tertiary care hospital in Delhi
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