A Clinical and Etiological Study of Patients with pancytopenia – A one year cross Sectional study at KLES Dr. Prabhakar Kore hospital and Medical Research Centre, Belgaum

Abstract

Background and Objectives ABSTRACT Pancytopenia means a disorder in which all three blood elements ( RBCs, WBCs and platelets) are decreased than normal although it is a common clinical problem with an extensive differential diagnosis, there is a relatively little discussion of this abnormality. Detailed work up is generally required for total evaluation of such case. The objective of the present study was to determine various clinical presentations and etiological factors of pancytopenia. Methods The present cross sectional study was conducted in Department of Medicine, at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum during January 2008 to December 2008 on 50 patients ( age ≥15 years) presenting with pancytopenia. Detailed history, clinical examination, blood investigations and bone marrow examination were performed. Other investigations like bone marrow trephine biopsy, serological tests, chest X-ray and electrophoresis were performed as necessary. Results In all cases, megaloblastic anemia constituted the largest group ( 36% ) , followed by aplastic anemia ( 16% ) , Malaria ( 10% ) and acute leukemias ( 10% ) . Other causes as determined in the present study were myelodysplastic syndrome ( MDS ) , hypersplenism, disseminated tuberculosis, multiple myeloma, human immunodeficiency virus infection, immune thrombocytopenic purpura ( ITP ) , dengue fever and septicemia. The most common symptom was easy fatigability VIII ( 90% ) followed by fever ( 70% ) and decrease appetite ( 40% ) . Pallor ( 100% ) and splenomegaly ( 52% ) were the most common physical findings. Conclusion Megaloblastic anemia and aplastic anemia were the common causes of pancytopenia followed by malaria and acute leukemias. Bone marrow study or trephine biopsy was helpful in most of the cases to find out etiology.