Clinico-pathological Study of Pancytopenia: A Prospective Study
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2019, Vol 6, Issue 10
Abstract
Background and Objectives: Pancytopenia is an important hematological entity. It is a disorder in which all three major formed elements of blood are decreased in number. The present study has been undertaken to find out various causes of pancytopenia by evaluation of bone marrow findings so that the data will help the clinician in better management of patients. Materials and Methods: It was a prospective study conducted in the Department of Pathology in King George Hospital, Visakhapatnam, a teaching institute and tertiary hospital in over a period of 1 year. Patients were referred to pathology from the departments of medicine and pediatrics for investigations on suspicion of pancytopenia. The patients were evaluated clinically along with hematological parameters and bone marrow aspiration biopsy. It was carried out in 68 patients from November 2016 to December 2017. Hemogram was obtained using five-part automated analyzer. Bone marrow aspiration was performed using Salah needle from the posterior superior iliac crest and from the medial aspect of tibial tuberosity in children <4 years. Bone marrow aspiration smears were stained using Leishman’s stain and Giemsa stain. Results: Among the 68 patients studied, the age of the patients varied from 3 years to 76 years with a male predominance. Most of the patients presented with fever and generalized weakness. The most common physical finding was pallor. Dimorphic anemia was the predominant blood picture. The most common bone marrow finding was erythroid hyperplasia with megaloblastic maturation. The most common cause of pancytopenia was megaloblastic anemia (64.7% of cases) followed by hypersplenism (10.2% of cases). Other causes include aplastic anemia, leukemia, idiopathic thrombocytopenic purpura, tuberculosis, lymphoma, and multiple myeloma. Conclusion: Detailed clinical history and physical examination along with hematological investigations and bone marrow aspiration biopsy are helpful for understanding the disease process and to diagnose the cause of pancytopenia. Identification of correct cause will help in implementing appropriate therapy. This study helps in identifying the incidence of various causes of pancytopenia.
Authors and Affiliations
Y S N Srinivas, Praveen Kumar Lakinena
Keywords
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