MEGALOBLASTIC ANAEMIA WITH MORPHOLOGICAL CHANGES IN MEGAKARYOCYTES- A PROSPECTIVE STUDY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 11
Abstract
BACKGROUND Megaloblastic anaemia is a nutritional anaemia that results from inhibition of DNA synthesis during red blood cell production. Thrombocytopenia in a case of megaloblastic anaemia may result from many mechanisms such as: marrow hypoplasia (decreased megakaryocytes), ineffective thrombopoiesis (normal to increased megakaryocytes) and increased destruction of platelets (increased megakaryocytes). The objectives of this study were- 1. to correlate clinicohaematological features in megaloblastic anaemia and bone marrow aspiration study of thrombocytopenia secondary to megaloblastic anaemia, hypoproduction and hyper-destruction 2. to understand the various megakaryocytic alterations in haematological disorders presenting with thrombocytopenia due to different mechanisms. MATERIALS AND METHODS 50 cases of thrombocytopenia aged between 01 to 13 years were included in the study. Bone marrow finding in 14 cases of thrombocytopenia of megaloblastic aetiology were compared with 32 cases of marrow proven hypo-productive thrombocytopenia (aplastic anaemia, acute leukemia) and 04 cases of hyper destructive thrombocytopenia (immune thrombocytopenia). RESULTS Most common age group presenting with megaloblastic anaemia is 11- 13 year, with male to female ratio is 1:1, most common complaints were generalized weakness and fever. In megaloblastic anaemia 64%, 22% and 14% of the cases shows increase, decrease and normal megakaryocytes respectively. Dysplastic megakaryocytes were observed in 21%, 40% and 25% of the cases of megaloblastic anaemia, acute leukemia and immune thrombocytopenic purpura respectively. CONCLUSION Both hypo production and ineffective thrombopoiesis are the underlying pathological mechanisms in megaloblastic thrombocytopenia as evidenced by the bone marrow aspiration findings. We here by infer that megaloblastic thrombocytopenia is to be included as a separate category apart from hypo proliferative and hyper destructive groups. The presence of dysplastic megakaryocyte should not confirm the diagnosis of myelodysplastic syndromes and dysplastic changes can occur in nonmyelodysplastic syndromes.
Authors and Affiliations
Poonam Bhajanlal Nanwani, Sativan Tannumal Khatri
Keywords
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- EP ID EP615534
- DOI 10.18410/jebmh/2019/176
- Views 76
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