Abstract :
Background: Pancytopenia is a relatively common hematological entity. It is a striking feature of many serious and life threatening illnesses ranging from simple drug – induced bone marrow hypoplasia, megaloblastic marrow to fatal bone marrow aplasias and leukemias. The severity of pancytopenia and the underlying pathology determines the management and prognosis. Thus, identification of the correct cause will help in implementing appropriate therapy.
Objectives: To study the clinical presentations in pancytopenia due to various causes. To evaluate hematological parameters including bone marrow aspiration and trephine biopsy wherever possible.
Materials and Methods: This is a prospective study to evaluate patients with pancytopenia who presented to hematology unit, department of pathology, KIMS, Hubli over a period of two years. Patients on chemotoxic therapy and radiotherapy were excluded from the study.
Results: A total of 115 patients were evaluated in this study. Among 115 cases, age of patients ranged from 3 – 80 years with a mean age of 42 years with male predominance. Male to female ratio was 1.5: 1. Most of the patients presented with generalized weakness and fever. Commonest physical finding was pallor followed by splenomegaly and hepatomegaly. Dimorphic anemia was the commonest blood picture. Bone marrow aspiration was conclusive in all cases. Commonest marrow finding was hypercellularity with megaloblastic erythropoiesis.
Conclusion: Pancytopenia is not an uncommon hematological problem encountered in clinical practice and should be suspected on clinical grounds when a patient presents with unexplained anemia, prolonged fever and tendency to bleed. Hence, present study concludes the detailed primary hematological investigations along with bone marrow aspiration and bone marrow trephine biopsy in cytopenic patients is helpful for understanding the disease process, to diagnose or to rule out the causes of cytopenia. It is also helpful in planning further investigations and management.
Keyword :
Pancytopenia, Megaloblastic anemia, Bone marrow aspiration, Bone marrow trephine biopsy.