scholarly journals A Clinico-Haematological Study of Causes of Pancytopenia

2021 ◽  
Vol 10 (40) ◽  
pp. 3533-3537
Author(s):  
Arvind Chouhan ◽  
Fuzail Ahmad ◽  
Manisha Jain
Keyword(s):  
Bone Marrow ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Unknown Origin ◽  
Bone Marrow Examination ◽  
Care Hospital ◽  
Cross Sectional ◽  
Smear Examination ◽  
Cellular Components ◽  
Haematological Study

BACKGROUND This is a clinic-haematological study, conducted in Sidhanta Hospital, Bhopal, to identify the causes of pancytopenia. Out of total 1200 cases of complete hemograms, 56 cases were categorized as pancytopenias, and out of these, 24 cases were subjected to bone marrow examination. The remaining 32 cases of pancytopenia, were put on periodic follow up with peripheral blood smear examination, based on clinical data. Pancytopenia is the simultaneous presence of anaemia, leucopenia and thrombocytopenia that may result from various disease processes, involving the bone marrow primarily or secondarily. Pancytopenia is reduction in all the three cellular components of the blood, namely red blood cells (RBCs), leucocytes (WBCs) and platelets. It is a common entity which is encountered by practitioners. The presentation is in the form of cytopenias leading to infections, anaemia, or bleeding manifestations. All the cases of pancytopenia need a through approach to reach to the cause of the same so that it can be managed in the best possible manner. Cytopenias are reduction in any of the three cellular components of the blood i.e. RBCs, WBCs or platelets. It can be reduction in two cellular components (bicytopenia) or a reduction in all the three cellular components (pancytopenia). In bicytopenia, the most common combination to be seen is anaemia and thrombocytopenia, whereas the least common is leucopenia with thrombocytopenia. (1) For practical purposes, it should have haemoglobin < 10 g%, absolute neutrophil count < 1,500/cumm and platelets < 1,00,000/cumm. It is labelled as severe when the three values are < 7 g%, < 500/cumm and < 20,000/cumm respectively. The purpose of this study was to find out different causes of pancytopenia and the use of bone marrow examination in evaluation of pancytopenia. METHODS This is a cross sectional study, conducted exclusively in the Department of Medicine, at a tertiary care hospital, in Bhopal from August 2019 to December 2019. A total of 56 cases of pancytopenia were analysed with clinico-haematological features. Criteria for diagnosis of pancytopenia were: Haemoglobin less than 10 gm/dl, TLC less than 4000/mm3 and platelet count less than 1,00,000/mm3. We have correlated the complete hemogram findings with bone marrow examination (if required) and peripheral smear examination in order to analyse the root cause of every case of pancytopenia. Pancytopenia is a haematological entity, we have to analyse the cause of it in order to find out the correct diagnosis and treat the patient accordingly. Bone marrow examination is useful in the investigation of PUO (pyrexia of unknown origin), as it leads to an etiological diagnosis in many of the cases. RESULTS In these 56 cases, only 24 cases (42.85 %) were subjected for bone marrow examination. Commonest cause of pancytopenia was episode of viral fever constituting 28 cases (50 %). CONCLUSIONS In cases of PUO, bone marrow examination is a very useful investigation. In cases diagnosed as idiopathic thrombocytopenic purpura (ITP), when the patient does not show improvement in counts, a repeat bone marrow examination should be done, as very rarely; acquired amegakaryocytic thrombocytopenia may be the cause. Though bone marrow examination is an absolute indication in cases of pancytopenia, it is important to wait for at least 2 – 3 weeks, and do a repeat hemogram, especially in cases of viral fever where the counts usually improve after fever subsides. KEY WORDS Pancytopenia, Bone Marrow, Viral Fever

A comparative study of bone marrow aspirate with trephine biopsy in pancytopenia disorders

2021 ◽  
Vol 6 (3) ◽  
pp. 201-206
Author(s):  
Kavya J ◽  
Kalpana Kumari MK
Keyword(s):  
Bone Marrow ◽  
Sensitivity And Specificity ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Care Hospital ◽  
Trephine Biopsy ◽  
Hematological Disorders ◽  
Hematoxylin And Eosin

Pancytopenia is commonly reported in clinical hematology practice. Due to its varied marrow pathology and underlying ailments, diagnosis is often misleading and delayed. Bone marrow examination would provide a comprehensive diagnosis of both blood and bone marrow, since aspirate investigates the cytological morphology and biopsy evaluates the cellularity, architecture, and compact marrows.To compare bone marrow aspiration and trephine biopsy results in the diagnosis of pancytopenia, and to determine the sensitivity and specificity of aspirate examination in pancytopenia diagnosis.This prospective study was conducted at a tertiary care hospital from July 2014 to June 2016. A total of 320 samples were received at the department of pathology for bone marrow examination (aspirate and biopsy). Romanowsky (Leishman) stain was used to investigate aspirate samples. All biopsy samples were processed into 3-5 μ blocks and stained using hematoxylin and eosin after decalcification with 5.5% EDTA. Data analysis was performed using SPSS19.Pancytopenia constituted 56 (18.7%) cases with the mean age of 41.79 years. Of the total pancytopenia cases, hematological disorders constituted 50 (89.3%) cases and 6 (10.7%) were non-hematological cases. Aspirate and biopsy diagnosis positively correlated in 76.79% of cases. A 100% sensitivity and specificity of aspirate diagnosis was observed in, acute myeloid leukemia, hypersplenism, myelodysplastic syndrome, megaloblastic anemia, hematological malignancy in remission and negative for lymphoma infiltrate. Aspirate had no role in diagnosis of uremic osteodystrophy and myelofibrosis, whereas leishmaniasis was diagnosed on aspirate alone.Pancytopenia includes multiple underlying ailments which requires a differential diagnosis approach. Combining both aspirate and biopsy for diagnosis would benefit the patient in prognosis as they are complementary to each other.

scholarly journals HAEMATOLOGICAL DISORDERS DIAGNOSED IN ONE HUNDRED AND ONE SUCCESSIVE BONE MARROW EXAMINATION AT A TERTIARY CARE CENTRE IN QUETTA, BALOCHISTAN

2021 ◽  
Vol 71 (2) ◽  
pp. 672-75
Author(s):  
Sunila Tashfeen ◽  
Naveed Asif ◽  
Shafia Nasir ◽  
Muhammad Azam ◽  
Zareen Irshad
Keyword(s):  
Bone Marrow ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Unknown Origin ◽  
Bone Marrow Examination ◽  
Military Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Haematological Disorders

Objective: To determine the frequency of haematological disorders diagnosed by bone marrow examination at a tertiary care centre in Quetta, Balochistan. Study Design: Prospective observational study. Place and Duration of Study: Department of Pathology, Combined Military Hospital Quetta, from Jan 2018 to May 2019. Methodology: A total of 101 one patients, who underwent bone marrow examination, were included in the study. Brief history, clinical examination and indication of procedure were also endorsed in a questionnaire designed for the study. Results: Bone marrow of one hundred and one patients, included in the study, were evaluated. Mean age of the patients was 32.3 ± 18.4 years. There were 68 males (67%), while 33 were females (33%) with 2:1 male to female ratio. Pyrexia of unknown origin (PUO) was the most common indication for bone marrow examination with frequency of 20.7%. Nutritional anaemia was the most prevalent benign disorder (17%), whereas Acute Lymphoblastic leukaemia (ALL) accounted about 6.8% which is highest in malignant disorders. Conclusion: This study has concluded that bone marrow examination is a useful technique and findings of bone marrow can modify the treatment. Thus procedure has a great diagnostic value. Both bone marrow aspiration (BMA) and bone marrow biopsy (BMB) are the complimentary techniques and supremacy of one method on other depends on the disorder.

scholarly journals Aetiology of Fever of Unknown Origin: One-Year Experience in a Tertiary Care Hospital of Bangladesh

2016 ◽  
Vol 6 (1) ◽  
pp. 7-11
Author(s):  
Muhammad Abdur Rahimi ◽  
AKM Shaheen Ahmed ◽  
Md Delwar Hossain ◽  
Md Raziur Rahman ◽  
Swapan Kumar Ghosh ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Lupus Erythematosus ◽  
Fever Of Unknown Origin ◽  
Tertiary Care ◽  
Unknown Origin ◽  
Care Hospital ◽  
Cross Sectional ◽  
Extra Pulmonary Tuberculosis ◽  
Common Causes ◽  
Extra Pulmonary

Background: Fever of unknown origin (FUO) is not an uncommon problem in general medical practice. Sometimes extensive investigations fail to reach an aetiological diagnosis; on the other hand, in few cases, fever resolves spontaneously. This study was aimed to evaluate the aetiology of FUO in a tertiary care setting.Methods: This cross-sectional study was done in the Department of Internal Medicine of BIRDEM General Hospital, Dhaka, Bangladesh from July 2012 to June 2013.Results: Among the 33 patients studied (1.23% of total admissions), 22 (66.7%) were male. Mean age of the study population was 40.2±7.9 years. Most patients (84.8%) were diabetic. Infection (20, 60.6%) was the commonest cause, followed by malignancy (9, 27.3%). Among the infective causes (20), extra-pulmonary tuberculosis (5, 25%) was the commonest, followed by liver abscess (4, 20%). Other less common causes were Kala-azar (1), malaria (2), histoplasmosis (2), melioidosis (1), cholecystitis (1), renal abscess (1), rickettsial fever (1), apical dental abscess (1) and infective endocarditis (1). Non-Hodgkin’s lymphoma (6), renal cell carcinoma (2) and hepatocellular carcinoma (1) constituted the malignant causes of FUO in this series. Systemic lupus erythematosus was the aetiology of FUO in 1 case. One case remained undiagnosed and 2 patients left hospital before a definite diagnosis could be made.Conclusion: Extra-pulmonary tuberculosis and non-Hodgkin’s lymphoma were the two most common causes of FUO in this study. Repeated history taking, clinical examinations and careful stepwise investigations can diagnose the aetiolgy in most cases of FUO.Birdem Med J 2016; 6(1): 7-11

scholarly journals BONE MARROW EVALUATION IN PATIENTS WITH PANCYTOPENIA- A CLINICO-HAEMATOLOGICAL STUDY IN A TERTIARY CARE HOSPITAL IN NORTH INDIA

2019 ◽  
Vol 8 (29) ◽  
pp. 2311-2315
Author(s):  
Neetu Purwar ◽  
Anita Omhare ◽  
Mahendra Singh ◽  
Dev Prakash Shivhare ◽  
Brijendra Nath Tripathi
Keyword(s):  
Bone Marrow ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Bone Marrow Evaluation ◽  
Haematological Study

EVALUATION OF PANCYTOPENIA IN ADULTS PATIENTS OF BIHAR

2021 ◽  
pp. 6-7
Author(s):  
Rachana Rachana ◽  
Nivedita Singh ◽  
Om Prakash Diwedi
Keyword(s):  
Bone Marrow ◽  
Complete Blood Count ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Clinical History ◽  
Bone Marrow Examination ◽  
Underlying Disease ◽  
Care Hospital ◽  
Detailed Clinical History

INTRODUCTION– Pancytopenia usually indicates presence of serious underlying disease. Determining the etiology of pancytopenia is important for appropriate management of the patients. AIMS AND OBJECTIVES- This study was undertaken to identify the etiological factors leading to pancytopenia in a tertiary care hospital of Bihar. MATERIAL AND METHODS– This was a prospective study conducted over 12 months in the department of pathology, Nalanda medical college, Patna. The study included adult patients (>18yrs) who had pancytopenia in complete blood count. Relevant blood tests and bone marrow aspiration (BMA) and bone marrow biopsy (BMB) were done to delineate the etiology of pancytopenia. RESULTS– The commonest cause of pancytopenia in our study was aplastic anemia (46.67%) followed by megaloblastic anemia (23.33%) and hematological malignancies (acute leukemia and lymphoma- 15%). Other causes include infective diseases (kala-azar, malaria and tuberculosis), hypersplenism and hemophagocytosis. CONCLUSION- Determination of etiology of pancytopenia needs detailed clinical history and physical examination, and appropriate hematological tests and bone marrow examination.

scholarly journals Spectrum of hematological diseases diagnosed by bone marrow examination in a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 185-189
Author(s):  
M Atchyuta ◽  
◽  
P Premalatha ◽  
I V Renuka ◽  
P A. V Krishnamashary ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Bone Marrow Examination ◽  
Care Hospital ◽  
Hematological Diseases

scholarly journals Maternal tobacco use and risk for congenital anomalies

2019 ◽  
Vol 6 (4) ◽  
pp. 1472
Author(s):  
Prabhuswami Hiremath ◽  
R. P. Patange ◽  
J. A. Salunkhe ◽  
Vaishali R. Mohite ◽  
Ajit Pawar ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Birth Defects ◽  
Rural Women ◽  
Tertiary Care ◽  
Circulatory System ◽  
Unknown Origin ◽  
Care Hospital ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Maternal Tobacco Use

Background: Over a period of decades non genetic causes are controlled and mortality and morbidity is considerable reduced due to malformation. Although 50% of causes for malformation are unknown origin, but, with primary prevention 50% of birth defects could be prevented. Research for finding the risk factors are continuous and such results would help to implement preventive strategies to improve maternal and child health.Methods: This is cross sectional; hospital based study, conducted in Krishna Hospital Karad, included all the Pregnant Mother diagnosed to have congenital birth defected foetus through antenatal examinations, delivered baby with diagnoses of congenital malformation, who were admitted at tertiary care hospital Karad.Results: Total 283 cases were diagnosed with birth defects. Parent’s history for tobacco use states that 16 (5.7%) mothers and 149 (53%) of fathers of malformed babies used tobacco. Among these 16 (5%) tobacco user mothers, maximum babies 5 (1.7 %) babies had born with neural tube defect and among fathers 149 (53%) maximum babies 41 (14%) circulatory system defect.Conclusions: There is a need to make the rural women aware about hazardous effects of use of mishri through health education sessions to wean them out of this addiction, which is passed from one generation to the next as a tradition at an early age.

scholarly journals Evaluation of bone marrow in cases of pancytopenia in a tertiary care hospital

2015 ◽  
Vol 5 (9) ◽  
pp. 691-695
Author(s):  
S Vaidya
Keyword(s):  
Bone Marrow ◽  
Aplastic Anemia ◽  
Tertiary Care Hospital ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Care Hospital ◽  
Diagnostic Modality ◽  
Number Of Patients

Background: A spectrum of primary and secondary disorders that affect the bone marrow may manifestwith pancytopenia. This study was carried out to identify the various causes of pancytopenia in patients attending a tertiary care hospital in Lalitpur, Nepal.Materials and Methods: A descriptive study of 83 cases of pancytopenia was carried out in the Department of Pathology, Patan Academy of Health Sciences, Lalitpur, Nepal over a two year period from August 2010 to July 2012.Results: Eighty three patients underwent bone marrow examination. Mean age of the patients was 34 years (range: 4 to 75 years). Maximum number of patients (31.33%) was seen in the age group of 16 - 30 years. The commonest cause of pancytopenia was megaloblastic anemia which was seen in 34.94% (29/83) cases followed by aplastic anemia and hematological malignancies in 31.32% (26/83) and 14.46% (12/83) cases, respectively.Conclusion: This study concluded that megaloblastic anemia and aplastic anemia were the two most common causes of pancytopenia. Bone marrow aspiration is an established diagnostic modality in the evaluation of pancytopenia.Journal of Pathology of Nepal (2015) Vol. 5, 691 - 695

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