An observational study on the common causes leading to pancytopenia in patients presenting to tertiary care hospital in south India
Bharath Jagdish Manakame, Kiran Aithal
Background & Objective: Pancytopenia is a striking feature of many serious and life threatening illnesses and may be caused by several disorders ranging from simple drug-induced bone marrow hypoplasia and megaloblastic anemia to fatal aplastic anemia and leukemia’s. The present observational study was conducted to find out the causes leading to pancytopenia, their distribution among the study cohort and their clinico-pathologic features. The primary outcome was to analyze the clinico-haematological parameters including bone marrow aspiration and finding out the common disease entities leading to pancytopenia.Methods: A hospital based prospective observational study was undertaken among the adult patients diagnosed/presented with Pancytopenia at SDM College of Medical Sciences & Hospital, Dharwad, Karnataka, India. A detailed meticulous physical examination as well as history of recent viral infections, fever, and weight loss, bleeding from various sites (gums, nose, mouth and vagina) were noted. And laboratory analysis, Peripheral blood smear examination, Bone marrow aspiration were recommended.Results: Out of total 105 patients, about 51.4% of the study subjects were males while remaining 48.6% were females. Our maximum study population were > 60 years (42.9%) with mean age 72.3 ± 7.7 years, followed by patients between 50 – 59 years (20%) with mean age 54.1 ± 2.5 years. Megaloblastic anemia (36.2%) was found to be the commonest cause of pancytopenia whereas aplastic anemia (26.7%) was the second most common etiology. 6.7% of the total cases were diagnosed as MDS while Acute Promyelocytic Leukemia was recorded in 9.5%. Five cases of Acute Lymphocytic Leukemia were also recorded with marked hypercellular bone marrow.Conclusion: The present study concludes that detailed primary investigations of hematological parameters along with bone marrow aspiration in cytopenic patients are helpful for understanding the underlying etiology; to diagnose, or to rule out the causes of cytopenia; and in planning further investigations and management of such patients. Megaloblastic anemia followed by Aplastic anemia still remains the major etiology related to pancytopenia as far as Indian setting is concerned.