A prospective study among cases of the pancytopenia on the basis of clinic-hematological analysis and bone marrow aspiration

Background: Pancytopenia is consequence of many haematological condition with an extensive differential diagnosis. A prompt intervention is required to avoid complications. The severity and the underlying pathology determines the management and prognosis. Present study was conducted to assess the etiology, clinical profile and bone marrow morphology of pancytopenia.Methods: A prospective study was carried out among 50 consecutive patients with pancytopenia. Blood samples of the patients were analyzed for complete blood count and peripheral smear along with presence and absence of immature cells and abnormal cells. In bone marrow examination, morphology of all cells lineage, cellularity, parasite and abnormal cells were scrutinized. Trephine biopsy was done if indicated. Special investigations were done to confirm the diagnosis.Results: Among the 50 cases studied, age of the patients ranged from 1 to 70 years with a slight male predominance. Most common age group 11-20 years. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. The commonest marrow finding was hyper cellularity with megaloblastic erythropoiesis. The commonest cause for pancytopenia was megaloblastic anemia.Conclusions: The present study concludes that hematological investigations along with other supportive tests are helpful to diagnose or to rule out the causes of pancytopenia. Megaloblastic anemia is commonest cause of pancytopenia in most Indian and subcontinent studies. Substantial 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 and management.

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Pancytopenia: A Clinico Hematological Study

Journal of Laboratory Physicians ◽

10.4103/0974-2727.78555 ◽

2011 ◽

Vol 3 (01) ◽

pp. 015-020 ◽

Cited By ~ 34

Author(s):

Gayathri B N. ◽

Kadam Satyanarayan Rao

Keyword(s):

Bone Marrow ◽

Megaloblastic Anemia ◽

Hematological Parameters ◽

Disease Process ◽

Bone Marrow Aspiration ◽

Drug Induced ◽

Male Predominance ◽

Bone Marrow Hypoplasia ◽

Life Threatening ◽

A Prospective Study

ABSTRACT Background: Pancytopenia is a relatively common hematological entity. It is a striking feature of many serious and life-threatening illnesses, ranging from simple drug-induced bone marrow hypoplasia, megaloblastic anemia to fatal bone marrow aplasias and leukemias. The severity of pancytopenia and the underlying pathology determine the management and prognosis. Thus, identification of the correct cause will help in implementing appropriate therapy. Objectives: To study the clinical presentations in pancytopenia due to various causes; and to evaluate hematological parameters, including bone marrow aspiration. Materials and Methods: It was a prospective study, and 104 pancytopenic patients were evaluated clinically, along with hematological parameters and bone marrow aspiration in Hematology Unit, Department of Pathology, JJMMC, Davanagere, during the period of September 2005 to September 2007. Results: Among 104 cases studied, age of patients ranged from 2 to 80 years with a mean age of 41 years, and male predominance. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. Dimorphic anemia was the predominant blood picture. Bone marrow aspiration was conclusive in all cases. The commonest marrow finding was hypercellularity with megaloblastic erythropoiesis. The commonest cause for pancytopenia was megaloblastic anemia (74.04%), followed by aplastic anemia (18.26%). Conclusion: The present study concludes that detailed primary hematological investigations along with bone marrow aspiration in cytopenic patients are helpful for understanding disease process and to diagnose or to rule out the causes of cytopenia. These are also helpful in planning further investigations and management.

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Clinicohematological Study of Pancytopenia in a Tertiary Care Hospital of Western Region of Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.3265 ◽

2017 ◽

Vol 56 (207) ◽

pp. 319-324 ◽

Cited By ~ 1

Author(s):

Dilasma Ghartimagar ◽

Arnab Ghosh ◽

Sushma Thapa ◽

Deepa Sapkota ◽

Adarsh Kumar Jhunjhunwala ◽

...

Keyword(s):

Bone Marrow ◽

Megaloblastic Anemia ◽

Hematological Parameters ◽

Tertiary Care ◽

Bone Marrow Aspiration ◽

Metastatic Carcinoma ◽

Care Hospital ◽

Male Predominance ◽

Hypoplastic Marrow ◽

A Prospective Study

Introduction: Pancytopenia is a relatively common hematological entity and is a manifestation of many illnesses which can be life threatening at times. The severity of pancytopenia and the underlying pathology determine the management and prognosis. This study was conducted to evaluate hematological and bone marrow findings in patients presenting with pancytopenia. Methods: It was a prospective study carried out in Department of Pathology, Manipal College of Medical Sciences, Pokhara, Nepal, during the period of January 2011 to December 2016. Clinical and hematological parameters including bone marrow aspiration and biopsy were evaluated in all patients who presented with pancytopenia. Results: Among 138 cases studied, patient’s age ranged from 2 to 82 years with a mean age of 43.95 years, and there was male predominance. Most of the patients presented with generalized weakness, pallor, dypnoea and fever. Hypoplastic marrow was seen in 38(27.5%) cases, followed by megaloblastic anemia 26 (18.8%) cases and acute leukemia 19(13.76%) cases. Other findings included one each case of hemophagocyosis, leishmaniasis, plasmodium vivex malaria and metastatic carcinoma. Conclusions: This study highlights that pancytopenia is a common hematological problem and the study of detailed primary hematological investigations along with bone marrow study in patients with pancytopenia will help to identify the cause for further planning and management. Keywords: hypoplastic marrow; leukemia; megaloblastic anemia; pancytopenia.

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Clinic-etiological profile of pancytopenia in children: a tertiary care center based study of Kumaun region, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20184275 ◽

2018 ◽

Vol 5 (6) ◽

pp. 2173

Author(s):

Ramesh Chand ◽

Nutan Singh

Keyword(s):

Bone Marrow ◽

Complete Blood Count ◽

Megaloblastic Anemia ◽

Care Center ◽

Tertiary Care ◽

Geographical Area ◽

Bone Marrow Examination ◽

Male Predominance ◽

Kala Azar ◽

Abnormal Cells

Background: Pancytopenia is not a disease entity but a triad of findings in which all blood cell lineages i.e leukocytes, erythrocytes and platelets are reduced in blood .It is consequence of various medical conditions. Present study was conducted to assess the etiology, clinical profile and bone marrow morphology of pancytopenia.Methods: A cross sectional prospective study was carried out among 42 children of age between 1 to 15 year with pancytopenia. Blood samples of the patients were analyzed for complete blood count and peripheral smear along with presence and absence of immature cells and abnormal cells. In bone marrow examination, morphology of all cell’s lineage, cellularity, parasite and abnormal cells were scrutinized. Trephine biopsy was done if indicated. Special investigations were done to confirm the diagnosis.Results: Among the 42 cases studied, age of the patients ranged from 1 to 15 years with a slight male predominance. Most of the patients presented with generalized weakness and weight loss and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. The commonest cause for pancytopenia was megaloblastic anemia Among the non-haematological causes kala azar 5 (11.9%) is the leading cause in this study.Conclusions: The present study concludes that detailed primary haematological investigations along with bone marrow examination in pancytopenic patients are helpful for diagnosis and management. This study also suggests that megaloblastic anaemia, dimorphic anaemia and kala-azar should also be included in differential diagnosis of pancytopenia in this geographical area.

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A Prospective Study to Assess the Bone Marrow Aspiration for Findings of Patients with Hematological Disorders

Asian Journal of Medical Research ◽

10.21276/ajmr.2019.8.2.pt2 ◽

2019 ◽

Vol 8 (2) ◽

pp. PT04-PT06

Author(s):

Sushma Singh Rathore ◽

Keyword(s):

Bone Marrow ◽

Prospective Study ◽

Bone Marrow Aspiration ◽

Hematological Disorders ◽

A Prospective Study

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A prospective study on morphological alteration of megakaryocytes amongst megaloblastic anemia cases along with their clinic-haematological manifestations

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20173996 ◽

2017 ◽

Vol 5 (9) ◽

pp. 4127

Author(s):

Benazeer Mansuri ◽

Komal P. Thekdi

Keyword(s):

Bone Marrow ◽

Megaloblastic Anemia ◽

Bone Marrow Aspiration ◽

Morphological Alteration ◽

Age Group ◽

Female Ratio ◽

Hematological Disorders ◽

Common Complaint ◽

A Prospective Study ◽

Male To Female

Background: Megaloblastic anemias are hematologic disorders in which abnormal DNA synthesis causes blood and bone marrow disorders. The cause of thrombocytopenia in megaloblastic anemia has been postulated as hypoproduction in some studies, whereas ineffective thrombopoeisis has been proposed in other. Objective was to study spectrum of clinic-hematological features in megaloblastic anemia and comparative bone marrow aspiration study of thrombocytopenia secondary to megaloblastic anemia, hypoproduction and hyper-destruction. This study was done to understand the various megakaryocytic alterations in hematological disorders presenting with thrombocytopenia due to different mechanisms.Methods: Total 85 cases of thrombocytopenia included in the study. Bone marrow finding in 33 cases of thrombocytopenia of megaloblastic etiology were compared with 34 cases of marrow proven hypo productive thrombocytopenia (aplastic anemia, acute leukemia) and 19 cases of hyper destructive thrombocytopenia (immune thrombocytopenia).Results: Most common age group presenting megaloblastic anemia is 11-20 year, with male to female ratio is1.2:1, most common complaint were generalized weakness and fever. In megaloblastic anemia 24.33%, 60% and 15.67% of the cases shows increase, decrease and normal megakaryocytes respectively. Dysplastic megakaryocytes were observed in 24.3%, 27% and 20.5% of the cases of megaloblastic anemia, acute leukaemia and immune thrombocytopenic purpura respectively.Conclusions: Both hypoproduction and ineffective thrombopoiesis are the underlying path mechanisms in megaloblastic thrombocytopenia as evidenced by the marrow findings. We hereby infer that megaloblastic thrombocytopenia is to be included as a separate category apart from hypo proliferative and hyper destructive groups. The presence of dysplastic megakaryocyte should not prompt an interpretation

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Pain assessment and factors influencing pain during bone marrow aspiration: A prospective study

PLoS ONE ◽

10.1371/journal.pone.0221534 ◽

2019 ◽

Vol 14 (8) ◽

pp. e0221534 ◽

Cited By ~ 2

Author(s):

Nicolas Gendron ◽

Sara Zia Chahabi ◽

Géraldine Poenou ◽

Nadia Rivet ◽

Tiphaine Belleville-Rolland ◽

...

Keyword(s):

Bone Marrow ◽

Prospective Study ◽

Pain Assessment ◽

Bone Marrow Aspiration ◽

Factors Influencing ◽

A Prospective Study

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Evaluation of Thrombocytopenia: A Prospective Study at Sree Balaji Medical College and Hospital, India

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i20a31349 ◽

2021 ◽

pp. 64-73

Author(s):

Tirumala Kanakadurga Sripati ◽

S. Palaniandavan ◽

. Govindarajan ◽

J. Thanka

Keyword(s):

Bone Marrow ◽

Prospective Study ◽

Megaloblastic Anemia ◽

Vital Role ◽

Specific Diagnosis ◽

Medical College ◽

Appropriate Treatment ◽

Common Causes ◽

The Common ◽

A Prospective Study

Thrombocytopenia is a physiological deficiency in platelet counting. Fragmented RBC can be a chronic trigger for a subclinical micro angiopathy that results in chronic consumption of platelets. The platelet is a small, lentiform, anucleated cell that play a vital role in hemostasis and are produced in the bone marrow from megakaryocytes. To evaluate different etiological factors of thrombocytopenia by the study of clinical profile and laboratory parameters in patients with thrombocytopenia carried out in Sree Balaji Medical College and Hospital, Chennai. After evaluating all cases of thrombocytopenia, it is concluded that infective causes are more common than non-infective causes. Infections like dengue, malaria and septicemia were the common causes of thrombocytopenia along with megaloblastic anemia. Whenever thrombocytopenia is detected, a further investigation has to be done for specific diagnosis in the most of the cases so that appropriate treatment can be given.

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EVALUATION OF PANCYTOPENIA IN ADULTS PATIENTS OF BIHAR

10.36106/ijsr/2006035 ◽

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.

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