Diagnostic Approach of New-Onset Pancytopenia: Study from A Tertiary Care Center
Pancytopenia 2 Years Retrospective Study
DOI:
https://doi.org/10.21276/apalm.1875Keywords:
Pancytopenia, bone marrow, leukemia, infectionAbstract
Background:
Pancytopenia is a disorder associated with decrease in number of all three major formed elements of blood (red blood cells, white blood cells and platelets). It is a triad of findings resulting from many disease processes. This may be associated with various hematopoietic and non-hematopoietic condition involving the bone marrow. The management and prognosis of patients with pancytopenia is based on the severity of pancytopenia and the underlying disease process. The present study helps in highlighting the role of various laboratory parameters in conjunction with clinical findings in evaluation of these patients.
Methods:
The present retrospective study was done for 2 years from April 2015 to April 2017 in Department of Pathology. A total of 210 patients with pancytopenia were included in the study. A detailed history and hematological findings including the bone marrow findings and flow cytometric results were noted in these patients, wherever available.
Result:
Out of 210 patients, 136 were adults and 74 were children. The mean age of the patients was 42 years. The male to female ratio was 2.7:1. The most common clinical feature in our study was pallor (in all cases) followed by fatigue (70.9%). Most of the cases had severe anemia (57.8%). Megaloblastic anemia was found to be the most common cause, constituting 61.9% of all cases, followed by hypersplenism (25.7%), aplastic anemia (9%), leukemia (1.9%). Occasional cases of kala-azar, typhoid and malaria was also noted.
Conclusion:
A proper clinico-hematological examination aids in making a proper diagnosis in patient presenting with pancytopenia. Sometimes, specific clinical features point towards a certain disease process. Various laboratory parameters can help in diagnosing the underlying disorder leading to pancytopenia. This diagnostic approach will facilitate to highlight the significance of various diagnostic modalities.
References
2. Gayathri BN, Rao KS. Pancytopenia: A clinico hematological study. J Lab Physicians 2011;3:15-20.
3. International agranulocytosis and aplastic anemia study. Incidence of aplastic anemia: The relevance of diagnostic criteria. Blood 1987;70:1718-21.
4. Kumar R, Kalra SP, Kumar H, Anand AC, Madan H: Pancytopenia – a six year study. J Assoc Physicians India 2001, 49:1078–1081.
5. Iqbal W, Hassan K, Ikram N, Nur S: Aetiological breakup of 208 cases of pancytopenia. J Rawal Med Coll 2001, 5:7–10.
6. Savage DG, Allen RH, Gangaidzo IT, et al. Pancytopenia in Zimbabwe. Am J Med Sci 1999; 317:22-32.
7. Khunger JM, Arculselvi S, Sharma U, Ranga S, Talib VH. Pancytopenia-A Clinico-hematological study of 200 cases. Indian J PatholMicrobiol 2002;45:375-9.
8. Knodke K, Marwah S, Buxi G, Vadav RB, Chaturvedi NK. Bone marrow examination in cases of pancytopenia. J Academy Clin Med 2001;2:55-9.
9. 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, 51:806-812
10. Malik AS. Complications of bacteriologically confirmed typhoid fever in children. J Trop Pediatr 2002; 48:102-8
11. Arya TV, Prasad RN. Fatal pancytopenia in falciparum malaria. J Assoc Physicians India 1989; 37:469-70.
12. Ohno T, Shirasaka A, Sugiyama T, Furukawa H. Hemophagocytic syndrome induced by Plasmodium falciparum malaria infection. Int J Hematol 1996; 64:263-6.
13. Aouba A, Noguera ME, Clauvel JP, Quint L. Haemophagocytic syndrome associated with plasmodium vivax infection. Br J Haematol 2000; 108:832-3.
14. Zvulunov A, Tamary H, Gal N. Pancytopenia resulting from hemophagocytosis in malaria. Pediatr Infect Dis J 2002; 21:1086-7.
15. Bhatnagar SK, Chandra J, Narayan S, Sharma S, Singh V, Dutta AK. Pancytopenia in children: Etiological profile. J Trop Pediatr 2005;51:236-9
16. Gupta V, Tripathi S, Tilak V, Bhatia BD. A study of clinico-haematological profiles of pancytopenia in children. Trop Doct 2008;38:241-3
17. Tilak V, Jain R. Pancytopenia- a clinico-hematological analysis of 77 cases. Indian J Pathol Microbiol 1999;42:399-404.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2018 Vijay Kumar, Manika Khare, Manjari Kishore, Megha Sharma, Sadhna Marwah, A.S. Nigam, Pratap Singh
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).