Published: 2018-03-28

Clinical profile of patients with pancytopenia in a tertiary care centre

Jyotsana ., Khan Afreen, Vishakha Sharma, Prem Kapur, Smita Manjavkar, Vineet Jain, Sunil Kohli, Anwar Habib


Background: Pancytopenia is a condition in which all three cell lines i.e. erythroid, myeloid and megakaryocytic are affected resulting in anaemia, leukopenia and thrombocytopenia. It can be a manifestation of a wide variety of disorders which primarily or secondarily affect the bone marrow. Early diagnosis of these conditions will help in implementing the appropriate treatment. The objective of the study was to know the clinical presentation and etiology of patients presenting with pancytopenia.

Methods: A one year study from April 2016 to March 2017 was conducted in the department of medicine at a tertiary care centre. Total 32 patients with pancytopenia were studied to determine their clinical features and etiology through relevant investigations.

Results: Our study revealed megaloblastic anaemia (46.87%) as the most common cause of pancytopenia, followed by malaria (12.5%). Other causes included hypothyroidism (6.2%), hypersplenism (6.2%), drugs (12.5%) and miscellaneous (9.43%).

Conclusions: Megaloblastic anaemia was found to be the major cause of pancytopenia in patients. Other causes of pancytopenia were malaria, drugs, hypersplenism and hypothyroidism. These should be kept in mind while evaluating patients with pancytopenia.


Anaemia, Malaria, Megaloblastic anaemia, Pancytopenia

Full Text:



Osama I, Baqai HZ, Faiz A, Nisar H: Patterns of pancytopenia patients in a general medical ward and a proposed diagnostic approach. J Ayub Med Coll Abbottabad. 2004:16:3-7.

Guinan EC, Shimamura A. Acquired and inherited aplastic anemia syndromes. In: Greer JP, Foerster J, Lukens JN, Rodgers GM, Paraskevas F, Glader B, eds. Wintrobe's Clinical Hematology. 11th Ed. Philadelphia: Lippincott Williams and Wilkins; 2004:1397-1419.

Khunger JM, Arculselvi S, Sharma U, Ranga S, Talib VH. Pancytopenia-A Clinico-haematological study of 200 cases. Indian J Pathol Microbiol. 2002;45(3):375-9.

Tilak V, Jain R. Pancytopenia - A Clinico hematologic analysis of 77 cases. Indian J Pathol Microbiol. 1999;42(4):399-404.

De Gruchy GC. Pancytopenia, aplastic anemia. In: Firkin F, Chesterman C, Penington D, Rush B, eds. De Gruchy’s Clinical Hematology in Medical Practice. 5th Ed. Berlin, Germany: Blackwell Science; 1989:119-136.

Khodke K, Mariah S, Buxi G, Yadav RB, Chaturvedi NK. Bone marrow examination in cases of pancytopenia. J Indian Acad Clin Med. 2001;2:55-9.

Hossain MA, Akond AK, Chowdhary MK, Singh KJ, Ahluwalia G, Sharma SK, et al. Pancytopenia - A study of 50 cases. Bangladesh J Pathol. 1992;1:9-12.

Chi-wai AL. Pancytopenia secondary to hypopituitarism may just be due to hypothyroidism alone. Ann Hematol. 2010;89:1181.

Tsoukas MA. Pancytopenia in Severe Hypothyroidism. The American Journal of Medicine. 2014:127(9):e11-e12.

Nakao S, Harada M, Kondo K, Mizushima N, Matsuda T. Reversible bone marrow hypoplasia induced by alcohol. Am J Hematol. 1991;37(2):120-3.

Lim AYN, Gaffney K, Scott DGI. Methotrexate-induced pancytopenia: serious and under-reported? Our experience of 25 cases in 5 years. Rheumatology. 2005;44(8):1051-5.