Original article / research
Pancytopenia: Clinical and Haematological Profile from a Tertiary Care Centre in Central India
Dr. Shweta Jain,
Type IV-101, New Campus, SGPGIMS, Lucknow, Uttar Pradesh, India.
Introduction: Pancytopenia is a characterised by the decrease in number of red blood cells, white blood cells, and platelets. It is not a final diagnosis; instead, a manifestation of underlying haematological and other disorder. No study has been carried out to evaluate the cause of pancytopenia from this region. The majority of the Western world studies suggest aplastic anaemia as a significant cause of pancytopenia. However in India, the pancytopenia causes are not well defined and varied. Earlier studies from India show megaloblastic anemia being the primary cause of pancytopenia.
Aim: To investigate the clinical and haematological correlation of pancytopenia and to ascertain aetiopathological causes of pancytopenia in patients admitted to a tertiary care center.
Materials and Methods: This prospective cross-sectional study was conducted from August 2012 to August 2014 at RD Gardi Medical College, Ujjain, a total of 100 consecutive patients with two or all three of the following inclusion criteria were enrolled: Haemoglobin <10 gm/dL Total Leukocyte Count (TLC) <4000/µL and platelet count <1,00,000/µL. All patients underwent complete hemogram, peripheral smear, and reticulocyte count evaluation. Bone marrow aspiration was also performed in all patients, and in addition, a trephine biopsy was done in the same setting in 23 patients. Data were analysed using standard statistical methods. Various sign, symptoms of pancytopenia were recorded and analysed.
Results: Underlying cause of pancytopenia was ascertained with the help of blood picture of bone marrow aspiration and biopsy, fatigue was the most common symptom (54%) followed by fever (49%) and breathlessness (15%). Pallor was detected in 85% of patients, splenomegaly in 47%, followed by hepatomegaly, oedema, lymphadenopathy, icterus, and ascites. Megaloblastic anemia was found to be the most prevalent cause of pancytopenia, which was seen in 49% of patients and followed by hypersplenism (16%).
Conclusion: Pancytopenia is not an uncommon condition and should be suspected on clinical grounds when a patient presents with unexplained anaemia, fatigue and prolonged fever. Along with the clinical examination, the haematological study includes peripheral smear, bone marrow aspiration and bone marrow biopsy plays a critical role in the diagnosis.
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