Pancytopenia.pdf - Pathology Section Original Article DOI NJLM/2013/6782:1995 Clinico – Hematological Analysis of Pancytopenia A Bone Marrow Study

Pancytopenia.pdf - Pathology Section Original Article DOI...

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National Journal of Laboratory Medicine. 2013 Dec, Vol 2(4): 12-17 12 DOI: NJLM/2013/6782:1995 Original Article 11 ABSTRACT Background: Pancytopenia is characterized by anemia, leucopenia and thrombocytopenia, a common hematological problem. It is a striking feature of many serious and life threatening illnesses. The disease pattern varies in different population groups, in age pattern, nutritional status and prevalence of infective disorder. Present study was conducted to assess the etiology, clinical profile and bone marrow morphology of pancytopenia. Objective: To know various patterns of clinical presentation and co-relate hematological parameters and bone marrow study with clinical findings, in differentiating causes of pancytopenia. Methods: A two-years study from January 2009 to December 2010 was conducted in Department of Pathology. Total 106 pancytopenia patients aged 15-65 years were studied to determine their clinical features, peripheral smear study and bone marrow morphology. The etiological pattern was assessed through relevant investigations done on the respective patients. Results: Bone marrow study showed 68.8% hypercellular marrow, 15% normocellular and 16.2 % hypocellular marrow. Males(57.5%) were affected more than females(42.5%) and the commonest cause for pancytopenia was megaloblastic anemia (73.5%), followed by iron deficiency anemia (12.2%), malaria(3.7%), leukemia (2.8%), SLE (1.8%), aplastic anemia (1.8%), multiple myeloma (0.9%), myelofibrosis(0.9%), MDS(0.9%) and hyperspleenism (0.9%). Conclusion: Large number of patients had reversible etiology. Hence complete work up including clinical details with hematological examination along with bone marrow study will lead to early and proper diagnosis of case followed by proper treatment. INTRODUCTION Pancytopenia is an important clinico-hematological entity encountered in our day-to-day clinical practice. The clinical pattern varies and thus treatment modalities and outcome III also varies [1]. Pancytopenia is not a disease entity but a triad of findings that may result from number of disease processes [2]. It is the simultaneous presence of anemia, leucopenia and thrombocytopenia, therefore it exists when hemoglobin is less than 13.5g/dl in males, 11.5g/dl in females, the WBC count <4 x 10 9 /L and platelet count <150x10 9 /L [3]. Presenting symptoms are usually attributable to anemia, leucopenia or thrombocytopenia. Anemia leads to fatigue,dyspnea and cardiac symptoms. Thrombocytopenia leads to bruising, mucosal bleeding and neutropenia to sharply increased susceptibility to infection [3]. The spectrum of disorders primarily or secondarily affecting the bone marrow may manifest with peripheral pancytopenia [4]. It is recommended that Bone Marrow Aspiration and Biopsy be done simultaneously in cases of pancytopenia. Aspiration smears are superior for morphological details while biopsy provides a more reliable index of cellularity and often reveals bone marrow infiltration, fibrosis and granulomas [5].
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  • Fall '17
  • michael j.moran

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