Common Cause Of Pancytopenia Research Articles

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BACKGROUND Pancytopenia is a relatively common haematological entity with simultaneous presence of anaemia, leucopenia and thrombocytopenia. It is a feature of many medical and haematological disorders like megaloblastic anaemia, drug-induced bone marrow hypoplasia, even fatal leukaemia and bone marrow aplasia. The clinical and haematological studies determine the proper diagnosis and management of patients. Bone marrow examination is an important diagnostic procedure for determining the cause of pancytopenia. This study was conducted to evaluate clinico-haematological findings, identify the causes of pancytopenia, and compare our findings with other similar studies. METHODS The four-year retrospective study was carried out in the Department of Pathology at a tertiary care hospital in western Odisha, India. Data regarding clinical details, peripheral blood and bone marrow aspirations were collected and analyzed using simple statistical methods. RESULTS A total of 131 cases of pancytopenia were studied. The age range of patients was 3 years to 72 years, with a mean of 36.5 years. Male to female ratio was 0.84 : 1. The majority of cases were in the age group of 31 – 40 years (20.61 %). Generalized weakness with pallor (54.96 percent) was the commonest clinical finding, followed by splenomegaly (16.79 %), and hepatomegaly (11.45 %). Aplastic anaemia (43.51 %) was the most common cause found on the bone marrow aspiration followed by megaloblastic anaemia (22.14 %) and haematological malignancies. Among the haematological malignancies, acute myeloid leukaemia was the commonest cause of pancytopenia (10.69 %). CONCLUSIONS Bone marrow aspiration in cytopenic patients helps in understanding the disease process and to diagnose or rule out the causes of cytopenia. Different geographical areas have a different presentation of haematological disorders. KEYWORDS Bone Marrow Aspiration, Pancytopenia, Aplastic Anaemia

CLINICO HEMATOLOGICAL PROFILE OF PATIENTS WITH PANCYTOPENIA- A THREE-YEAR STUDY

Background: Pancytopenia is a relatively common hematological entity. It may result from relatively benign causes such as viral infections and vitamin B12/folic acid deciency to more fatal bone marrow aplasia and leukaemias. The severity of pancytopenia and the underlying pathology determine the management and prognosis. Objectives: To study the etiology and clinic-hematological prole in patients of peripheral blood pancytopenia. Materials And Methods: This was a retrospective study conducted at G S Medical College, Hapur and Noida international institute of Medical Sciences Greater Noida, during the period of November 2017 to November 2020 Results: A total of 192 patients (103 males and 89 females) were diagnosed to have pancytopenia. Most of the patients presented with generalized weakness and fever. The commonest physical nding was pallor, followed by splenomegaly. The various causes of pancytopenia included infections(n=132), megaloblastic anaemia (MA)(n=46), drugs, aplastic anaemia and subleukaemic leukaemia. We found a signicant association between megaloblastic anaemia and pancytopenia. Conclusion: The present study concluded that infection and megaloblastic anaemia are the most common cause of pancytopenia. The more serious disorders affecting the bone marrow constitute only <5% of all cases of pancytopenia.

Clinico-Haematological Study of Pancytopenia

Introduction: Pancytopenia is a clinical condition, which refers to a combination of anaemia, leucopenia and thrombocytopenia. It often poses diagnostic challenge to physician and the knowledge of accurate etiologies of this condition is crucial in the management of the patient.
 Materials and Methods: The study was a prospective study done over a period of October 2011 to December 2011 and 50 patients were evaluated clinically along with haematological parameters, bone marrow aspiration and wherever required, a trephine biopsy was performed in Haematology department of Armed forces institute of pathology (AFIP), Dhaka cantonment, Dhaka. In all patients, a detailed relevant history along with a physical examination was done and data was collected using pre designed proforma.
 Results: Among the 50 cases studied, age of the patients ranged from 3 to 80 yrs with a mean age of 37.5 yrs and male predominance. Fever and generalized weakness were the most common symptoms. The commonest physical findings were pallor followed by splenomegaly and hepatomegaly. Anisopoikilocytosis and relative lymphocytosis was the most prominent peripheral blood findings in patients. The commonest cause of pancytopenia was Aplastic anaemia (36%), followed by Myelodysplastic syndrome (18%), visceral leishmaniasis (12%), Megaloblastic anaemia (8%), Acute leukaemia (6%), Myelofibrosis (4%), Multiple myeloma (4%), Hypersplenism (4%), Malaria (2%).
 Conclusion: As a large number of pancytopenic patients have a reversible aetiology, early & proper diagnosis may be life saving. Maximum diagnostic yield can be achieved by correlation with clinical findings & laboratory parameters.
 Medicine Today 2021 Vol.33(1): 12-18

A clinico-hematological evaluation of pancytopenia at government medical college and hospital, latur: A 2-year observational study

Context: Pancytopenia is defined by reduction of all the three formed elements of blood below the normal reference. Hematological investigation forms the bedrock in the management of patients with pancytopenia and therefore needs detailed study. The aim of this study was to identify the underlying etiologies of pancytopenia cases presenting at our institute with clinico-hematological evaluation. Materials and Methods: In this 2-year prospective study, 105 patients aged ≥15 years admitted in hospital with a hematological diagnosis of pancytopenia followed by bone marrow aspiration and/or biopsy after receiving an informed consent were studied. The criteria applied for pancytopenia were hemoglobin level: <13.5 g/dL for males and <11.5 g/dL for females; total leukocyte count: <4 × 109/L; and platelet count: <150 × 109/L. Pregnant women and patients aged <15 years along with those who did not give consent for bone marrow aspiration or biopsy were excluded. A detailed clinical examination was carried out in all cases. Results: In the present study, megaloblastic anemia (67.62%) was the most common cause of pancytopenia, followed by aplastic anemia (15.25%), leukemia (3.81%), malaria (3.81%), hypersplenism (3.81%), liver cirrhosis (1.90%), myelofibrosis (1.90%), multiple myeloma (1%), and enteric fever (1%). Conclusions: The severity of pancytopenia and the underlying pathology determine the management and prognosis. Thus, comprehensive clinical and hematological evaluation of pancytopenia cases will help in identification of the correct cause and in implementing the appropriate therapy.

Comparative evaluation of pancytopenia/bicytopenia in adult and pediatric population in a tertiary care centre through hematological parameters and bone marrow studies

Introduction: Pancytopenia/bicytopenia is not a disease per se rather a spectrum of changes pertaining to reduction in cell numbers. Its presentation as well as causes are diverse in adult and pediatric population. It is imperative to evaluate the causes of pancytopenia/bicytopenia in adults and pediatric subjects as well as to understand the significant differences in their etiology and manifestations. Aims and objectives: Comparative evaluation of pancytopenia/bicytopenia in adult and pediatric patients through hematological parameters and bone marrow studies. Materials and Methods: In this study, 80 adult and 40 pediatric patients of pancytopenia/bicytopenia were evaluated. Detailed history, examination, Hb, TLC, platelet count, MCV, PBS examination, Bone marrow studies were performed. Statistical analysis was done using one-way anova. Result: The commonest presenting age in children was between 12-16 years of age and 19-40 years in adults. Male to female ratio in adults was 1.94:1, while that of pediatric patients was 1:0.74. On bone marrow examination, most common cause of pancytopenia/bicytopenia among pediatric subjects was aplastic anemia (32.5%) followed by megaloblastic anemia(20%), acute leukemia (17.5%) , erythroid hyperplasia (15%). Megaloblastic anemia was the commonest cause of pancytopenia/bicytopenia among adult cases (37.5%) followed by erythroid hyperplasia (20%) and aplastic anemia (10%). Conclusion: Our study concludes that there is statistically significant difference between the values of Hb, TLC, Platelet and MCV among adult and pediatric patients of pancytopenia; implying that these hematologic parameters vary with respect to mean values and range between the two groups. We also conclude nutritional deficiency to be a common cause of pancytopenia in both the age groups. Keywords: Aplastic anemia, Megaloblastic anemia, Pancytopenia.

Frequency and Etiology of Pancytopenia in Patients Admitted to a Tertiary Care Hospital in Karachi.

IntroductionPancytopenia is an important hematologic problem encountered frequently in clinical practice characterized by a reduction in all three peripheral blood cell lineages, i.e., anemia, leucopenia, and thrombocytopenia, caused by myriad disease processes. Our study aimed to determine the frequency and etiology of pancytopenia in patients admitted under internal medicine services in a tertiary care hospital.MethodThis cross-sectional study was conducted in the in-patient internal medicine department, The Indus Hospital (TIH), Karachi, included 258 patients. To be eligible, participants had to give informed consent, be 14 years or older, and of either sex. The study involved a 20-30-minute interaction with the patient, involving an interview and physical examination, and access to electronic health record data.ResultsOut of 258 patients studied, 24 (9.3%) were diagnosed with pancytopenia, the male to female ratio was 1:1, no significant difference was observed in the proportion of ethnicity, religion, previous treatment, known infectious disease, and personal and occupational exposure among pancytopenic patients and other non-pancytopenic patients. Fever (n=14, 58.3%) was most common presenting complaint followed by fatigue (n=13, 54.2%) and weight loss (n=7, 29.2%) while most common signs were pallor (87.5% n=21), hepatomegaly (29.2%, n=7), and splenomegaly (25%, n=6). The most common cause of pancytopenia was megaloblastic anemia (n=10, 41.7%), followed by hypersplenism (n=4, 16.6%), acute infectious diseases (n=3, 12.5%), and autoimmune diseases (n=3, 12.5%).ConclusionOur study suggests that pancytopenia is a common finding among our patient population and a larger proportion has a treatable cause, thus carrying a favorable prognosis.

Bone Marrow Biopsy Evaluation in Cases of Pancytopenia-An Institutional Experience

Background: Pancytopenia is not a disease entity, but a triad of findings, resulting from various disease processes. It is characterized by anaemia, leucopenia and thrombocytopenia in the peripheral blood. Bone marrow examination is of utmost importance in evaluation of pancytopenia and thereby identification of disease process is helpful for appropriate management. Aims and Objectives: To analyse wide spectrum of haematological diseases giving rise to pancytopenia in bone marrow trephine biopsy. Materials and Methods: This was a prospective study conducted in the department of Pathology and Clinical Hematology, S.C.B. Medical College, Cuttack for a period of 2 years including 122 pancytopenia patients. Complete blood count including peripheral smear examination, followed by bone marrow aspiration (BMA) and trephine biopsy were carried out in all cases. Informations were compiled and analysed. Results: Among 122 patients studied, 63.1% were males and 36.9% females. Aplastic anaemia was the commonest cause of pancytopenia (51%) followed by megaloblastic anaemia (23%). Other causes include acute leukaemia 9%, MDS 6%, primary myelofibrosis 2%, lymphomatous infiltration in the marrow 2%, and multiple myeloma 3%. Metastatic deposit, tuberculosis, haemophagocytic syndrome and hypersplenism constituted 1% each. Conclusion: BMA and biopsy were diagnostic in all the cases of pancytopenia. Though in few cases BMA yields a dry tap & inconclusive coupled with bone marrow biopsy (BMB) it helps in defining diagnostic and therapeutic strategies in pancytopenia.

Clinico-etiological profile of pancytopenia in paediatric patients with special reference to bone marrow examination: A tertiary care centre based study

Context: Pancytopenia is a consequence of varied aetiology in paediatric age group. The aetiology can be determined by bone marrow assessment and clinical profile of patient.Aim: The aim of the study was to assess clinical profile, bone marrow morphology and to identify easily treatable and reversible causes of paediatric pancytopenia cases. Setting: Tertiary care centre in RajasthanStudy design: ProspectiveMethods and material: The study was conducted at the Department of Pathology, RNT Medical College, Udaipur, Rajasthan from January 2019 to December 2019. Patients aged 2 months to 15 years who had pancytopenia on peripheral blood smear and were admitted for bone marrow examination were included in the study. Detailed history and clinical profile were taken in all cases.Results: Out of 54 patients presenting with pancytopenia, the most common presenting complaint was generalized weakness (92.6%) followed by fever (77.78%). The most common physical finding was pallor (100%), followed by splenomegaly (42.60%) and hepatomegaly (40.74%). Megaloblastic Anaemia was the most common aetiology (48.15%) followed by Aplastic Anaemia (16.67%) and Acute Leukaemia (11.11%).Conclusion: As megaloblastic anaemia is the most common cause of pancytopenia and being an easily treatable condition, it should be taken into consideration before the more serious conditions like leukaemia and aplastic anaemia.

Pancytopenia in children-clinical and haematological evaluation

Pancytopenia is characterised by anaemia, leukopenia and thrombocytopenia. The common causes of pancytopenia in children are acute leukemia, nutritional deficiency anaemia, aplastic anaemia, bone marrow suppression (by drugs and various infections etc) and myelophthisic anaemia. Complete examination of the patient along with routine haematological investigation is very important in establishing the various causes of pancytopenia.

Study of etiological spectrum and clinical profile of patients admitted in tertiary care hospital of South Gujarat, India

Background: Pancytopenia is defined as reduction of all three formed elements of blood below normal reference range. The symptoms are fatigue, fever, dizziness and weight loss. Evaluation was done using complete hemogram and peripheral smear. The presenting marrow biopsy is most useful and accurate in evaluation of pancytopenia.Methods: Two ml of anticoagulated blood was collected for complete hemogram. The peripheral blood smear was stained with Leishman's stain and studied. Bone marrow biopsy and aspiration was done in all the patients to identify etiology.Results: Predominance was seen in the age group of 31-60 years. Most common cause of pancytopenia was megaloblastic anaemia in this study compared to other studies all over the world where most common cause was aplastic anaemia. This reflects higher prevalence of megaloblastic anaemia in the Indian subjects.Conclusions: A comprehensive clinical, haematological land bone marrow study of patients with pancytopenia usually helps in identification of the underlying cause.

A study of aetiology and clinical profile of 50 patients presenting with pancytopenia

Background: Pancytopenia is reduction of all the three cellular components which includes anemia, leukopenia and thrombocytopenia. Pancytopenia is striking feature of many serious and life threatening illness ranging from simple drug induced bone marrow hypoplasia, megaloblastic marrow to fatal bone marrow aplasia and leukemias. Pancytopenia has variety of etiologies but most common and reversible is Vitamin B12 deficiency, so early and accurate diagnosis may be lifesaving.Methods: Study conducted prospectively in 50 patients of pancytopenia with age &gt;12 years, who were admitted to department of medicine in Dr. M.K. Shah Medical College between 2018 to 2020. A complete clinical history and examination was carried out. They were evaluated for complete blood count with peripheral smear, liver function test, renal function test, vitamin B12 level, radiological imaging and bone marrow examination in selected patients.Results: The etiological causes of pancytopenia were recorded as vitamin B12 deficiency (n 30,60%), Infections (n11,22%),Hypersplenism (n 4;8%), aplastic anemia (n 3; 6%), Drug induced (n 1; 2%) and SLE (n1; 2%). Presenting symptoms in these patients were lethargy, malaise, generalized weakness, dyspnoea on exertion and fever while signs were pallor, splenomegaly and hyperpigmentation. All patients of megaloblastic anemia had macrocytic picture in peripheral smear and all of them were improved after treatment with vitamin B12 supplement.Conclusions: Pancytopenia is not an uncommon clinical entity and has various etiologies. Most common cause of pancytopenia was B12 deficiency and most common symptoms and signs were generalized weakness and pallor respectively. Most of the etiological causes could be diagnosed with laboratory analysis and radiological imaging without the need of a bone marrow examination.

Pancytopenia in children at hematology department, children hospital 1: clinico-haematological profiles and bone marrow examination – a case series

Objectives: To determine causes of pancytopenia in children via bone marrow aspiration at Hematology Department, Children hospital 1; clinical characteristics, time to diagnostic; peripheral blood smear and bone marrow examination. Sample: Children with pancytopenia and bone marrow examination performed, at Hematology Department, Children hospital 1, from July 2017 to May 2018. Design: Case-series study. Results: A total of 96 patients were admitted to our department for bone marrow aspiration for pancytopenia during the study period. The most common diagnosis was hemophagocytic lymphohistiocytosis (HLH), 58.3%, followed by acute lymphoblastic leukemia with 26.0% and acute myeloid leukemia with 4.2%. The median duration of diagnosis (from first symptom to bone marrow aspiration) was 13.5 days (range, 4–31 days) in malignancy, 10.5 days in HLH (range, 4–49 days), and 13 days in aplastic anemia or bone marrow hypoplasia (range, 8–23 days). The peripheral blood smear showed blasts CA/blast in 88.0% cases with leukemia. Bone marrow aspiration showed hypocellularity in 10.4%, normocellularity in 68.8%, hypercellularity in 20.8%. Conclusions: In our hospital the most common causes of pancytopenia were hemophagocytic lymphohistiocytosis followed by acute leukemia. Routinely following a panel of screening tests to all children with newly pancytopenia, including complete blood cell count and peripheral blood smear is recommended. Bone marrow aspiration should be considered early. A definitive diagnosis could be made based solely on a single bone marrow aspiration in a significant fraction of cases in pediatric pancytopenia; some cases may require clinical follow-up and/or repeat bone marrow aspiration/biopsy for definitive diagnosis.

Role of basic haematological investigations in the evaluation of pancytopenia

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.

Aetiology and Clinical Presentation of Pancytopenia in a Teaching Hospital

Pancytopenia is a morphological description of the peripheral blood picture irrespective of its cause &amp; it denotes simultaneous presence of anaemia, leucopenia and thrombocytopenia. The study was done to observe the demographic profile &amp; the clinical presentations of pancytopenic patients and to find out the aetiology of pancytopenia. This cross sectional study was carried out in Medicine ward of Rajshahi Medical College Hospital from August 2005 to July 2006. A uniform protocol was followed in all cases, to have appropriate history, physical findings &amp; laboratory investigations. The commonest cause of pancytopenia was aplastic anaemia (48%) which was followed by hypersplenism (22%) &amp; acute leukemia (16%). The majority cases of aplastic anaemia were idiopathic (57.69%), only 42.31% cases were due to secondary causes. The majority (94%) of patients was in the age range of 14-60 years and up to 54% was in the age group of 20-40 years. The ratio of male to female in patients of pancytopenia was 1.5:1 and 3:1 in aplastic anaemia. In secondary causes of aplastic anaemia, insecticides and viral hepatitis was found to be causative agent in 45.45% cases of each followed by pregnancy in 9.10% of cases. The common presenting complains of aplastic anaemia were generalized weakness (100%), gum bleeding (76.92%), fever (76.92%) and pallor (96.15%). Faridpur Med. Coll. J. Jul 2018;13(2): 62-65

Causes of pancytopenia based on bone marrow examination in adult patients presenting at Muhimbili National Hospital

Background Pancytopenia is the simultaneous presence of anaemia, leucopenia and thrombocytopenia. The aetiological spectrum of pancytopenia is wide and variable. We aimed to determine the common causes of pancytopenia by analyzing bone marrow aspiration records of adult patients seen at Muhimbili National Hospital, a tertiary care centre. Methods This was a retrospective descriptive cross-sectional study of all adult patients who presented with pancytopenia for a period of one year from January 2013 to December 2013. All patients with pancytopenia, i.e. Hb < 10 g/dl, WBC < 4 x 109/l and platelet count < 150 x 109/l; aged ≥ 18 years; and of both sexes were included in the study. The data obtained were entered on excel sheets, cleaned and analyzed for averages and ranges for numerical data. Categorical data were summarized by averages of frequencies and proportion. Results A total number of 216 adult patients had bone marrow examination in one year. A full blood picture was retrieved in 153 patients and among these, 26.8% (n = 41) had pancytopenia. The common causes of pancytopenia were aplastic anaemia (48.8%); haematological malignancies (29.3%); and nutritional anaemia (17.0%). Acute myeloid leukaemia was the commonest malignancy comprising 50% of all haematological neoplasms and iron deficiency occurred in 71.4% of nutritionally anaemic patients. Conclusion Aplastic anaemia was the most common aetiological factor followed by haematological malignancies among adult patients presenting with pancytopenia at Muhimbili National Hospital. The high frequency of iron deficiency anaemia with pancytopenia was unusual. Key words: pancytopenia, aetiology, bone marrow, adult patients

A study on incidence of vitamin B12 deficiency in patients with pancytopenia

Background: Pancytopenia is a serious and life threatening illness presented with multiple etiologies. The current study was done with the objective to evaluate the clinic-pathological factors responsible for incidence of pancytopenia in patients with vitamin B12 deficiency and their response to the therapy with vitamin B12.Methods: It was an observational study carried out at Department of Medicine, Mahatma Gandhi Memorial Government Hospital, Trichy, Tamilnadu during the period between December 2016 to December 2017. A total 50 patients with pancytopenia were clinically evaluated along with hematological parameters and bone marrow aspiration.Results: A total of 50 patients were included in the study. The mean age of the patients was 32.84 years with a male to female ratio of 1.5:1. All patients had history of fatigability. Commonest physical presentation was pallor (100%). Megaloblastic anaemia was the predominant blood picture in 58% patients. The common bone marrow finding was hyper cellular marrow with megaloblastic picture. Management with cyanocobalamin preparations and folate supplementations, significantly improved the reticulocyte count percentage in patients with pancytopenia (p=0.01)Conclusion: The study concluded that the most common cause of pancytopenia was megaloblastic anaemia. Detailed haematological investigations along with bone marrow aspiration in patients with cytopenia provided a clear understanding of disease process to identify the etiologies of pancytopenia.

CLINICO HAEMATOLOGICAL PROFILE IN PATIENTS OF PANCYTOPENIA AND ROLE OF NUTRITIONAL DEFICIENCIES AS IMPORTANT AETIOLOGICAL AND PREVENTABLE FACTOR IN CAUSING PANCYTOPENIA IN INDIA

Observational and descriptive cross-sectional study-150 patients, >18 yrs age,evaluated clinically with haematological parameters and bone marrow aspiration.RESULTS-Majority patients presented with fatigue, breathlessness(87.3%) and fever(52.7%). Commonest sign was pallor, followed by splenomegaly, hepatomegaly.Commonest BM picture was hypercellular.Most common aetiology was megaloblastic anaemia(34%),followed by infections(21.3%),hypersplenism(11.3%) and iron deficiency anaemia (8%).Nutritional deficiencies constituted 42% of cases.36% patients had normocellular bone marrow,54.6% patients had hypercellular bone marrow and 9.3% patients had hypocellular bone marrow.Hypocellular BM patients-severe anaemia(42.8%),moderate leucopenia (64.28%)& severe thrombocytopenia.Hypercellular BM patients-moderate anaemia(53.65%),moderate leucopenia(53.65%).CONCLUSION-clinical history & physical examination along with baseline haematological investigations and BMA(biopsy if needed) provide invaluable information, helping in systematic planning of further investigations to diagnose and acertain the cause,avoiding unnecessary tests which not only add to expense of treatment but sometimes may also delay diagnosis and treatment in pancytopenia patients. Pancytopenia is a triad of findings resulting from disease processes primarily or secondarily involving bone marrow ranging from megaloblastic anaemia, aplastic anaemia, disseminated kochs, enteric fever, leishmaniasis to lethal haematological malignancies so all these causes should be kept in mind while planning investigations for the workup of pancytopenic patients.Megaloblastic anaemia and iron deficiency anaemia were the most common causes of pancytopenia in our study which is easily treatable and reversible cause of pancytopenia and thus has a good prognosis.Its early diagnosis is important to prevent further complications.

A Spectrum of Hematological Disorders in Children with Pancytopenia Based on Bone Marrow Examination in a Tertiary Care Hospital.

IntroductionPancytopenia is a common presentation in the pediatric population. It is a manifestation of various diseases, and its etiology can be explained on the basis of bone marrow examination. The study aims to determine the etiological factors leading to pancytopenia via bone marrow examination in pediatric patients presenting in our hospital.Materials and methodsThis retrospective cross-sectional study was conducted in the Department of Pathology at a public sector tertiary care hospital. Data were recorded by convenience sampling from the patients’ database from January 2015 to April 2018. Patients aged 2 months to 15 years who had pancytopenia on peripheral blood smear and were admitted for bone marrow examination were included in the study. Patients who were beyond these age limits, diagnosed cases of aplastic anemia and leukemia, and those with a recent history of blood transfusion were excluded from the study. The analysis was done via the Statistical Package for Social Sciences (SPSS) v.23.0 (IBM SPSS Statistics, Armonk, NY, USA), and descriptive statistics were applied.ResultsOf 115 cases, 58 (50.4%) were males and 57 (49.6%) were females. Megaloblastic anemia was present in 32 (27.8%) patients, and it was the most common cause of pancytopenia. Non-malignant disorders were seen in 95 cases (82.6%) and malignant disorders were seen in 20 (17.4%) cases.ConclusionMegaloblastic anemia is the most common cause, and acute lymphoblastic leukemia is the most common malignant cause of pancytopenia in children. There was no significant gender predilection among causes of pancytopenia.

Clinico-Pathological Spectrum of Pancytopenia: A Single Centre Study

Pancytopenia is a common hematological condition in clinical practice which is characterized by the simultaneous presence of anemia, leukopenia andthrombocytopenia. To determine the frequency of pancytopenia, common etiology & presentation on the basis of bone marrow biopsy. This retrospective study was conducted at Diagnostic and Research Laboratory LUMHS Hyderabad during October 2014 to December 2016. Medical records, blood smear, bone marrow aspirate and biopsy findings of patients presenting with pancytopenia who full fill the inclusion criteria were analyzed. Relevant history, physical, systemic examination and hematological findings at presentation were recorded using a standard proforma after approval of institutional review board and signing of informed consent of patients and their guardian. Out of 351 cases 108 cases of pancytopenia males 61(56%) & females 47(43%). The majority of the patients are falling in pediatric age group 73(67%). Megaloblastic anemia was the most common cause of pancytopenia in 45(41%), followed by aplastic anemia in 24(22%), hypersplenism in 9(9%) and leukemia in 8(7.4%) cases. Megaloblastic anemia is the most common cause of pancytopenia with male predominance followed by Aplastic anemia and Hypersplenism.

Etiological and Clinical Spectrum of Pancytopenia Based on Bone Marrow Examination

Background: Bone marrow aspiration is assessed for cytology and trephine biopsy provides overall cellularity, detection of focal lesion and infiltration. Bone marrow study plays a crucial role in identifying cause of aplastic anaemia in clinical practice. This study was carried out to see the etiological and clinical spectrum of pancytopenia based on bone marrow examination.&#x0D; Materials and Methods: This descriptive study was conducted in the Department of Medicine, Dhaka medical college Hospital, Dhaka, Bangladesh over a 2-year period (August 2016 to July 2018). A total 80 cases of pancytopenia were included in the study. Patients were diagnosed by hemoglobin less than 10 gm/ dL, total leukocyte count less than 4000/Cumm and platelet count less than 150000/cumm.&#x0D; Results: Maximum number of cases were seen in age group of 16-30 years (31.25%) and male to female ratio is 1.1:1. The commonest presenting complaint was fever in 40% (32/80) of the cases. Pallor was present in all the patients, Splenomegaly was seen in 20% (16/80) and hepatomegaly in 12.5% of the cases (10/80). Petechial hemorrhages were present in 5% (4/80). The commonest cause of pancytopenia was megaloblastic anemia (35%) and followed by aplastic anemia (32.5%).&#x0D; Conclusion: Pancytopenia is a common clinical problem encountered in clinical practice and the major differential diagnostic considerations of pancytopenia are aplastic anemia, megaloblastic anemia and hematological malignancies.&#x0D; J MEDICINE JUL 2019; 20 (2) : 68-71