DOI: http://dx.doi.org/10.18203/2349-3933.ijam20160191

Clinical features and risk factors of pancytopenia: a study in a tertiary care hospital

Kande V. Mallikarjuna Rao, Kande V. Mallikarjuna Rao

Abstract


Background: Pancytopenia is one of the important hematological disorders seen in regular clinical practice, which is characterized by the decrease in all the three cellular elements of peripheral blood i.e. red blood corpuscles, white blood cells as well as platelets. The prevalence and risk factors are different in different geographical areas and hence this study was undertaken to identify the prevalence of pancytopenia in our area and analyse the risk factors.

Methods: 42 patients with pancytopenia, of all age groups and both the sexes were included in the study. A detailed demographic and clinical history was taken from the patients. All of them were subjected to thorough physical examination; blood tests were collected for hematological study. Bone marrow aspirate was also taken form these patients.

Results: Out of 42 patients, 54.8% patients were males and 45.3% were females, with most of them below 40 years of age. The most major cause of pancytopenia was megaloblastic anaemia comprising of 38.1% of the cases, followed by aplastic anaemia with 26.2%. The other minor contributors were leukaemia, malaria, malignancy, septicemia among others. Pallor, dyspnoea, fever were the most common symptoms observed.

Conclusions: The study shows that there is a great incidence of pancytopenia in younger and middle age group rather than in the elderly. Detailed hematological examination including bone marrow aspiration should be done in these patients to understand and diagnose this disease early so that proper intervention and management of these patients can be done.


Keywords


Pancytopenia, Hematological examination, Megaloblastic anemia, Aplastic anemia

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References


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

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 anaemia syndromes. 11th ed. Philadelphia: Lippincott Williams and Wilkins; 2004:1397-419.

Ujjan DI, Shaikh AI, Khokar AN, Memon AR, Farooq M. Frequency of causes of pancytopenia in patients admitted at Isra University Hospital Hyderabad. Pak J of Med Health Sci. 2010;4(4):416-8.

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

Nanda A, Basu S, Marwaha N. Bone marrow trephine biopsy as an adjunct to bone marrow aspiration. JAPI. 2002;50:893-5.

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.

Tareen SM, Bajwa MA, Tariq MM, Babar S, Tareen AM. Pancytopenia in two national ethnic groups of Baluchistan. J Ayub Med Coll Abottabad. 2011;23(2):82-6.

Gruchy D. Pancytopenia; aplastic anaemia. In: Firkin F, Chesterman C, Pennigton D, Rush B, editors. De Gruchy’s Clinical Hematology in Medical Practice. 5th ed. Oxford: Blackwell; 1989:119-36.

Gamal AH, Safa AR. Patterns of pancytopenia in Yemen. Turk J Hematol. 2008;25:71-4.

Mussarrat N, Fazl R. The incidence of underlying pathology in pancytopenia - an experience of 89 cases. J postgrad Instit. 2004;18:76-9.

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(1):060-5.

Gayathri BN, Rao KS. Pancytopenia: A clinico hematological study. Physicians Lab J. 2011;3:15-20.

Jain A, Naniwadekar M. An etiological reappraisal of pancytopenia - Largest series reported to date from a single tertiary care teaching hospital. BMC Hematol. 2013;13:10.

Pathak R, Jha A, Sayami G. Evaluation of bone marrow in patients with pancytopenia. J Nepal Med Assoc. 2012;2:265-71.

Hossain MA, Akond AK, Chowdhary MK, Sikder AM, Rashid MA. Pancytopenia- a study of 50 cases. Bangladesh Journal Pathol. 1992;7:9-12.

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

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.

Das Makheja K, Kumar Maheshwari B, 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.

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. Clinico-hematologic analysis of pancytopenia: study in a tertiary care centre. Basic and Applied Pathol. 2012;5:19-21.

Khodke K, Marwah S, Buxi G, Yadav RB, Chaturvedi NK. Bone marrow examination in case of pancytopenia. J Ind Aca Clin Med. 2001;2(1 & 2):55-9.

Jha A, Sayami G, Adhikari RC, Panta AD, Jha R. Bone marrow examination in cases of pancytopenia. J Nepal Med Assoc. 2008;47(169):12-7.

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.

Kumar R, Kalra SP, Kumar H, Anand AC, Madan M. Pancytopenia - a six year study. JAPI. 2001;49:1079-81.

Arya TV, Prasad RN. Fatal pancytopenia in falciparum malaria. J Assoc Physicians India. 1989;37(7):469-70.

Savage DG, Allen RH, Gangaidzo IT, Levy LM, Gwanzura C, Moyo A et al. Pancytopenia in Zimbabwe. Am J Med Sci. 1999;317:22-32.

Imbert M, Scoazec JY, Mary JY, Jouzult H, Rochant H, Sultan C. Adult patients presenting with pancytopenia: a reappraisal of underlying pathology and diagnostic procedures in 213 cases. Hematol Pathol 1989;3:159-67.

Gupta V, Tripathi S, Tilak V, Bhatia BD. A study of clinico-haematological profiles of pancytopenia in children. Trop Doct. 2008;38:241-3.