Clinical and hematological profile of pancytopenia in a tertiary care hospital of Southern Odisha, India
Keywords:Aplastic anemia, Dengue, Malaria, Megaloblastic anemia, Pancytopenia, Sepsis
Background: Pancytopenia (anemia, thrombocytopenia and leukopenia) is a common haematological condition with various etiologies like ineffective haematopoiesis, bone marrow suppression, bone marrow infiltration and peripheral destruction of blood cells. The present study was done to see the clinical features and etiologies of pancytopenia in this geographical region.
Methods: About 150 patients above 15 years of age after fulfilling the inclusion criteria were included in the study. They were evaluated with appropriate laboratory tests including bone marrow study, if indicated to find out the underlying etiology.
Results: Common symptoms were generalized weakness (93.3%), fever (75.3%) and dyspnoea (54%). Common physical findings were pallor (100%), lymphadenopathy (43.6%) and hepatosplenomegaly (32%). Most common causes were aplastic anemia (28%), megaloblastic anemia (20%) followed by infections like malaria (13.3%), dengue (5.3%) and sepsis (1.3%). Bone marrow was hypocellular in 50 patients (41.7%), hypercellular in 45 patients (37.5%) and normocellular in 25 patients (20.8%).
Conclusions: There are some reversible causes of pancytopenia like megaloblastic anemia, malaria, dengue and sepsis. Conditions like disseminated TB, collagen vascular diseases also can be treated with specific treatment if diagnosed early to avoid further complications.
Valent P, Low blood counts: immune mediated, idiopathic, or myelodysplasia. Hematol Am Soc Hematol Educ Program. 2012;485-91.
Young NS, Abkowitz JL, Luzzatto L. New insights into the pathophysiology of acquired cytopenias. Hematol Am Soc Hematol Educ Program. 2000.
Pascutti MF, Erkelens MN, Nolte MA. Impact of viral infections on hematopoiesis: from beneficial to detrimental effects on bone marrow output. Front Immunol. 2016;7:364.
Marks PW. Hematologic manifestations of liver disease. Semin Hematol. 2013;50(3):216-21.
Risitano AM, Maciejewski JP, Selleri C, Rotoli B, Function and malfunction of hematopoietic stem cells in primary bone marrow failure syndromes. Curr Stem Cell Res Ther. 2007;2(1):39.
Jain A, Naniwadekar M. An etiological reappraisal of pancytopenia-largest series reported to date from a single tertiary care teaching hospital. BMC Hematol. 2013;13(1):10.
Weinzierl EP, Arber DA. Bone marrow evaluation in new-onset pancytopenia. Hum Pathol. 2013;44(6):1154.
Shimamura A, Alter BP. Pathophysiology and management of inherited bone marrow failure syndromes. Blood Rev. 2010;24(3):101.
Khunger JM, Arculselvi S, Sharma U, Ranga S, Talib VH. Pancytopenia-a clinico-hematological study of 200 cases. Ind J Pathol Microbiol. 2002;45:375-9.
Kumar R, Kalra SP, Kumar H, Anand AC, Madan M. Pancytopenia-a six-year study. J Assoc Physicians India. 2001;49:1079-81.
Knodke K, Marwah S, Buxi G, Vadav RB, Chaturvedi NK. Bone marrow examination in cases of pancytopenia. J Acad Clin Med. 2001;2:55-9.
Gayathri BN, Rao KS. Pancytopenia: a clinico hematological study. J Lab Physicians. 2011;3:15-20.
Savith A, Mishra RR. Pancytopenia- a clinical and etiological study. Scholars J Appl Med Sci. (2015):3(5):1926-8.
Abdullah Mir TA, Bhat MH, Raina A. Etiological profile of pancytopenia in a tertiary care hospital of Kashmir Valley. Int J Sci Res. 2015;4:5-611.
Yadav BS, Varma A, Kiyawat P. Clinical profile of pancytopenia: a tertiary care experience. Int J Bioassays. 2014;4(1):3673-7.