A clinico-hematological study of pancytopenia in a tertiary care center

Abstract

Background: Pancytopenia is triad of findings characterized by reduction in all three major formed elements of the blood: erythrocyte, leukocytes and platelets. The present study has been undertaken to study the clinical profile of the patient’s presenting with pancytopenia, identify the underlying etiology leading to pancytopenia and bone marrow morphology due to various causes of pancytopenia. Materials and Method: An observational study was conducted on 100 patients of pancytopenia admitted in general medicine department. Selected patients were subjected for detailed clinical history, physical examination followed by lab investigations. Collected data were presented in tabulated or graphical form and were analyzed. Result: A total of 100 patients in the age range of 15- 85 years were taken in the study. There was male predominance with a male: female ratio of 2.2:1. Commonest clinical presentations were generalized weakness in 61% followed by fever in 47%. Most common physical findings were pallor observed in all patients followed by splenomegaly and hepatomegaly in 15 and 8 patients respectively. Bone marrow aspiration cytology showed hypercellular marrow in 62%, normocellular in 13% and hypocellular in 25%. Megaloblastic erthyopoeisis with hypercellular marrow were observed in 39 cases. 13 cases were diagnosed as acute leukemia and 02 cases were diagnosed as MDS. Hypocellular marrow was diagnosed in 25 cases out of which 18 cases were idiopathic aplastic anemia, 02 each of scrub typhus and SLE, 01 case each of post-partum aplastic anemia, disseminated tuberculosis and methotrexate induced. Normocellular marrow were observed in 04 cases of dimorphic anemia, 02 cases of Kala- azar, 01cases each of disseminated TB , falciparum malaria, metastatic adenocarcinoma and NHL. Conclusion: The present study concluded that Megaloblastic anemia is the most common and reversible cause of pancytopenia.