Clinico-hematological analysis of pancytopenia


  • Ramdas Jella Department of General Medicine, Bhaskara Medical College, Rangareddy, Telangana, India
  • Vasantha Jella Department of General Medicine, Bhaskara Medical College, Rangareddy, Telangana, India



Pancytopenia, Megaloblastic anemia, Aplastic anemia


Background: Pancytopenia is a manifestation of a wide variety of disorders which primarily or secondarily affect the bone marrow. It is a relatively common condition whose causative factors may vary with different geographical locations. Thus, to determine the causative agents and the clinical symptoms is essential for the management of this condition.

Methods: This study was conducted on 56 patients above the age of 18 years presenting with pancytopenia. All the patients were subjected to thorough clinical and physical examination. Blood samples were collected for complete blood analysis and biochemical tests and peripheral blood smear was taken. Urine and stool samples were also taken for occult blood analysis. Bone marrow aspiration and trephine biopsies were performed wherever necessary as per the clinical symptoms.

Results: Out of the 56 patients, 58.9% were males and 41.1% were females. The mean age of the patients was 34.9±4.3 years. The major presentation of the patients with pancytopenia was megaloblastic anemia, in 42.9 of the cases, followed by aplastic anemia in 23.2% of the cases. Among the common clinical symptoms, the most common one was pallor (73.2%) followed by weight loss (62.5%) and dyspnea (51.8%).

Conclusions: Megaloblastic anemia is the most common cause of pancytopenia followed by aplastic anemia, with pallor being the most common clinical symptom. Therefore, the clinical findings along with the hematological analysis along with bone marrow aspiration examination are very important for an early diagnosis of pancytopenia so that early intervention can be taken for the patient and enhance the survival rate.  

Pancytopenia, Megaloblastic anemia, Aplastic anemia


Williams WJ, Bentkr E, Erskv AJ. Haematology 3rd Ed. Singapore: McGraw Hill Book company; 1986:161.

Ishtiaq O, Baqai HZ, Anwer F, Hussai N. Patterns of pancytopenia patients in a general medical ward and a proposed diagnostic approach. J Ayub Med Coll Abbottabad. 2004;16(1):8-13.

Yadav BS, Varma A, Kiyawat P. Clinical profile of pancytopenia: a tertiary care experience. Intern J Bioassays. 2015;4(01):3673-7.

Azaad MA, Li YP, Zhang QR, Wang HX. Detection of pancytopenia associated with clinical manifestation and their final diagnosis. Open J Blood Dis. 2015;5:17-30.

Hayat AS, Khan AH, Baloch GH, Shaikh N. Pancytopenia: study for clinical features and etiological pattern of at tertiary care settings in Abbottabad. Professional Med J. 2014; 21:060-5.

Iqbal W, Hassan K, Ikram N, Nur S. Aetiological Breakup in 208 cases of Pancytopenia. J Rawal Med Coll. 2001;5(1):7-10.

Bird AR, Jacob P. Trephine biopsy of the bone marrow. S Afr Med J. 1983;64:271-6.

Winfield DA, Polacarz SV. Bone marrow histology. 3: valve of bone marrow core biopsy in acute leukaemia, myelodysplastic syndromes, and chronic myeloid leukaemia. J Clin Pathol. 1992;45:855-9.

Syed NN, Moiz B, Adil SN, Khurshid M. Diagnostic importance of bone marrow examination in non-haematological disorders. J Pak Med Assoc. 2007;57:123-5.

Wilkins BS, Bostanci AG, Ryan MF, Jones DB. Haemopoietic regrowth after chemotherapy for acute leukaemia: an immunohistochemical study of bone marrow trephine biopsy specimens. J Clin Pathol. 1993;46:915-21.

Rahim F, Ahmad I, Islam S, Hussain M, Khattak TAK, Bano Q. Spectrum of hematological disorders in children observed in 424 consecutive bone marrow aspirations/biopsies. Pak J Med Sci. 2005;21:433-6.

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

Varma N, Dash S. Reappraisal of underlying pathology in adult patients presenting with pancytopenia. Top Geogr med. 1982;44:322-7.

International agranulocytosis and aplastic anemia study. Incidence of aplastic anemia: the relevance of diagnostic criteria. Blood. 1987;70:1718-21.

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

Makheja DK, Maheshwari KB, Arain S, Kumar S, Kumari S, Vikash. The common causes leading to pancytopenia in patients presenting to tertiary care hospital. Pak J Med Sci. 2013;29:1108-11.

Dasgupta S, Mandal PK, Chakrabarti S. Etiology of pancytopenia: an observation from a referral medical institution of Eastern region of India. J Lab Physicians. 2015;7(2):90-5.

Prasad BH, Sarode S, Kadam DB. Clinical profile of pancytopenia in adults. Int J Sc Res. 2013;2(7):355-7.

Reddy GPK, Mallikarjuna Rao KV. Clinical features and risk factors of pancytopenia: a study in a tertiary care hospital. Int J Adv Med. 2016;3(1):68-72.

Agarwal R , Bharat V, Gupta BK, Jain S, ansal R, Choudhary A, Tiwari G. Clinical and hematological profile of pancytopenia. Intern J Clin Biochem Res. 2015;2(1):48-53.

Kumar DB, Raghupathi AR. Clinicohematologic analysis of pancytopenia: Study in a tertiary care centre. Basic and Applied Pathol. 2012;5:19-21.

Niazi M, Raziq F. The incidence of underlying pathology in Pancytopenia - an experience of 89 cases. J Postgrad Med Inst. 2004;18(1):76-9.

Naseem S, Varma N, Das R, Ahluwalia J, Sachdeva US, Marwaha RK. Pediatric patients with bicytopenia/pancytopenia: review of etiologies and clinic hematological profile at a tertiary centre. IJPM. 2011;54(1):75-80.

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






Original Research Articles