A study on incidence of vitamin B12 deficiency in patients with pancytopenia

Authors

  • G. Sathish Kumar Department of General Medicine, KAP Viswanatham Government Medical College, Trichy, Tamil Nadu, India
  • Swetha . Department of General Medicine, KAP Viswanatham Government Medical College, Trichy, Tamil Nadu, India
  • V. Rajendran Department of General Medicine, KAP Viswanatham Government Medical College, Trichy, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20194140

Keywords:

Pancytopenia, Reticulocyte percentage, Vitamin B12 deficiency

Abstract

Background: Pancytopenia is a serious and life threatening illness presented with multiple etiologies. The current study was done with the objective to evaluate the clinic-pathological factors responsible for incidence of pancytopenia in patients with vitamin B12 deficiency and their response to the therapy with vitamin B12.

Methods: It was an observational study carried out at Department of Medicine, Mahatma Gandhi Memorial Government Hospital, Trichy, Tamilnadu during the period between December 2016 to December 2017. A total 50 patients with pancytopenia were clinically evaluated along with hematological parameters and bone marrow aspiration.

Results: A total of 50 patients were included in the study. The mean age of the patients was 32.84 years with a male to female ratio of 1.5:1. All patients had history of fatigability. Commonest physical presentation was pallor (100%). Megaloblastic anaemia was the predominant blood picture in 58% patients. The common bone marrow finding was hyper cellular marrow with megaloblastic picture. Management with cyanocobalamin preparations and folate supplementations, significantly improved the reticulocyte count percentage in patients with pancytopenia (p=0.01)

Conclusion: The study concluded that the most common cause of pancytopenia was megaloblastic anaemia. Detailed haematological investigations along with bone marrow aspiration in patients with cytopenia provided a clear understanding of disease process to identify the etiologies of pancytopenia.

Metrics

Metrics Loading ...

References

Larry Jameson JL. Harrison’s principles of Internal Medicine. Megaloblasticanemias. 19th ed. Chapter 128. New York: McGraw Hill publishers; 2015: 640-644.

Williams WJ, Bentkr E, Erskv AJ. Hematology.3rd ed. Singapore: Mcgraw Hill Book company; 1986:161.

Knodke K, Marwah S, Buxi G, Vadav RB, Chaturvedi NK. Bone marrowexamination in cases ofpancytopenia. J Academy Clin Med. 2001;2:55-9.

Hohlfeld P, Forestier F, Kaplan C, Tissot JD, Daffos F. Fetal thrombocytopenia: a retrospective survey of 5,194 fetal blood samplings. Blood. 1994 Sep 15;84(6):1851-6.

Ulusoy E, Tüfekçi O, Duman N, Kumral A, Irken G, Oren H. Thrombocytopenia in neonates causes and outcomes. Ann Hematol. 2013;92(7):961-7.

Alter BP. Diagnosis, genetics, and management of inherited bone marrow failure syndromes. Hematology Am Soc Hematol Educ Program. 2007;2007(1):29-39.

Ishtiaq O, Baqai HZ, Anwer F, Hussain 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.

Aziz T, Ali L, Ansari T, Liaquat HB, Shah S, Ara J. Pancytopenia: megaloblastic anemia is still the commonest cause. Pak J Med Sci. 2010;26(1):132-6.

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.

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

Jella R, Jella V. Clinico-hematological analysis of pancytopenia. Int J Adv Med. 2016;3:176-9.

Gayathri B, Rao K. Pancytopenia: A clinic hematological study. J Lab Physicians. 2011;3(1):15-20.

Mansuri B, Thekdi KP. A prospective study among cases of the pancytopenia on the basis of clinico-hematological analysis and bone marrow aspiration. Int J Res Med Sci. 2017;5:3545-9.

Dubey TN, Nigotia P, Saxena R. The common causes leading to pancytopenia in patients presenting in hospital of central India. International J Contemporary Med Res. 2016;3(10):3027-30.

Unnikrishnan V, Dutta TK, Badhe BA, Bobby Z, Panigrahi AK. Clinico-aetiologic profile of macrocytic anaemias with special reference to megaloblasticanaemia. Indian JHematol Blood Transfusion. 2008;24(4):155-65.

Priya PP, Subhashree AR. Role of absolute reticulocyte count in evaluation of pancytopenia-a hospital based study. J Clin Diagn Res. 2014;8(8):1-3.

Johnson CS, Omata M, Tong MJ. Liver involvement in sickle cell disease. Medicine. 1985;64(5):349-56.

Garg AK, Agarwal AK, Sharma GD. Pancytopenia: Clinical approach. Chapter 95. 2017:450-4.

Manzoor F, Karandikar MN, Nimbargi RC, Pancytopenia: A clinico-hematological study. Med J DY Patil Univ. 2014;7(1):25-8.

Halfdanarson TR, Walker JA, Litzow MR, Hanson CA. Severe vitamin B12 deficiency resulting in pancytopenia, splenomegaly and leukoerythroblastosis. European J Haematol. 2008;80(5):448-51.

Yokus O, Gedik H. Etiological causes of pancytopenia: A report of 137 cases. Avicenna J Med. 2019;6(4):109-12.

Santra G, Das BK. A cross-sectional study of the clinical profile and aetiological spectrum of pancytopenia in a tertiary care centre. Singapore Med J. 2010;51(10):806-12.

Erlacher M, Strahm B. Missing Cells: Pathophysiology, Diagnosis, and Management of (Pan)Cytopenia in Childhood. Front Pediatr. 2015;3:64.

Downloads

Published

2019-09-23

How to Cite

Kumar, G. S., ., S., & Rajendran, V. (2019). A study on incidence of vitamin B12 deficiency in patients with pancytopenia. International Journal of Advances in Medicine, 6(5), 1402–1407. https://doi.org/10.18203/2349-3933.ijam20194140

Issue

Section

Original Research Articles