scholarly journals Clinical and hematological profile of pancytopenia in a tertiary care hospital of Southern Odisha, India

Author(s):  
Namita Mohanty ◽  
Arjun Nataraj Kannan ◽  
Nikhil Jain

Background: Pancytopenia (anemia, thrombocytopenia and leukopenia) is a common haematological condition with various etiologies like ineffective haematopoiesis, bone marrow suppression, bone marrow infiltration and peripheral destruction of blood cells. The present study was done to see the clinical features and etiologies of pancytopenia in this geographical region.Methods: About 150 patients above 15 years of age after fulfilling the inclusion criteria were included in the study. They were evaluated with appropriate laboratory tests including bone marrow study, if indicated to find out the underlying etiology.Results: Common symptoms were generalized weakness (93.3%), fever (75.3%) and dyspnoea (54%). Common physical findings were pallor (100%), lymphadenopathy (43.6%) and hepatosplenomegaly (32%). Most common causes were aplastic anemia (28%), megaloblastic anemia (20%) followed by infections like malaria (13.3%), dengue (5.3%) and sepsis (1.3%). Bone marrow was hypocellular in 50 patients (41.7%), hypercellular in 45 patients (37.5%) and normocellular in 25 patients (20.8%).Conclusions: There are some reversible causes of pancytopenia like megaloblastic anemia, malaria, dengue and sepsis. Conditions like disseminated Tb, collagen vascular diseases also can be treated with specific treatment if diagnosed early to avoid further complications.

2021 ◽  
Vol 6 (3) ◽  
pp. 201-206
Author(s):  
Kavya J ◽  
Kalpana Kumari MK

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.


Author(s):  
Nadia Shafi Chikan ◽  
Qazi Mohammad Iqbal ◽  
Altaf Hussain Mir

Background: Pancytopenia is not a disease by itself; rather it describes simultaneous presence of anemia, leukopenia and thrombocytopenia resulting from a number of disease processes. Varieties of hematological and non-hematological disorders may affect bone marrow either primarily or secondarily, resulting in the manifestation of pancytopenia. The incidence of various hematological disorders causing pancytopenia varies due to geographical distribution and genetic predisposition. This study highlights the spectrum of causes, clinical presentation and bone marrow morphology of pancytopenia.Methods: This prospective observational study was conducted for a period of two years at Al-Ameen Medical College, Bijapur, Bangalore. During this period, fifty patients with a hematological diagnosis of pancytopenia were studied during period in the department of pathology.Results: Among the 50 cases studied, 35 were males and 15 were females. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. Dimorphic anemia was predominant blood picture. Bone marrow study showed 72% hypercellular marrow, 12% normocellular and 16% hypocellular marrow. The commonest cause for pancytopenia was megaloblastic anemia followed by iron deficiency anaemia and malaria.Conclusions: The present study concludes that detailed hematological investigations along with bone marrow examination in pancytopenic patients is helpful to diagnose or rule out the causes of pancytopenia. 


2020 ◽  
Vol 7 (4) ◽  
pp. 616
Author(s):  
Mohnish M. Patel ◽  
K. N. Bhatt ◽  
Khyati T. Jariwala

Background: Pancytopenia is defined as reduction of all three formed elements of blood below normal reference range. The symptoms are fatigue, fever, dizziness and weight loss. Evaluation was done using complete hemogram and peripheral smear. The presenting marrow biopsy is most useful and accurate in evaluation of pancytopenia.Methods: Two ml of anticoagulated blood was collected for complete hemogram. The peripheral blood smear was stained with Leishman's stain and studied. Bone marrow biopsy and aspiration was done in all the patients to identify etiology.Results: Predominance was seen in the age group of 31-60 years. Most common cause of pancytopenia was megaloblastic anaemia in this study compared to other studies all over the world where most common cause was aplastic anaemia. This reflects higher prevalence of megaloblastic anaemia in the Indian subjects.Conclusions: A comprehensive clinical, haematological land bone marrow study of patients with pancytopenia usually helps in identification of the underlying cause.


2017 ◽  
Vol 56 (207) ◽  
pp. 319-324 ◽  
Author(s):  
Dilasma Ghartimagar ◽  
Arnab Ghosh ◽  
Sushma Thapa ◽  
Deepa Sapkota ◽  
Adarsh Kumar Jhunjhunwala ◽  
...  

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.


2018 ◽  
Vol 26 (2) ◽  
pp. 157-161
Author(s):  
Mohammad Zaid Hossain ◽  
Mohammad Manirul Islam ◽  
Masuma Ahmed Salsabil ◽  
Quadrat E Elahi ◽  
Mazharul Islam ◽  
...  

Pancytopenia is a triad of simultaneous presence of anemia, leucopenia and thrombocytopenia. It is result from a number of disease processes. Both hematopoietic and nonhematopoietic conditions manifest with features of pancytopenia.Methods: This was a cross-sectional study carried out in the Department of Medicine, Dhaka Medical College Hospital between December 2016 to July 2017. We included adult patients of both sexes having age 16 years and above. Criteria for inclusion were persistent pancytopenia on peripheral blood film of more than one week duration. All patients underwent a detailed medical history and full physical examination followed by blood sampling for the investigations. After taking all the aseptic measures and with standard technique the diagnostic bone marrow aspiration and trephine biopsy were done.Results: There were 36 patients with pancytopenia which were included in this study. There were 20 (56%) males and 16 (44%) females with a 1.25:1 male to female ratio and a mean age 47.30 years ± 15.01 SD. The most common complaints were bleeding manifestation (29/36), followed by generalized weakness (27/36) and fever (25/36). Anaemia was the most common (100%) clinical feature followed by jaundice and splenomegaly (6/36). Aplastic anemia was the commonest cause that was observed in 27.78% (10/36) cases followed by Megaloblastic anemia 16.67% (6/36) and erythroid hyperplasia 13.88% (5/36).Conclusion: Aplastic anaemia is leading cause of pancytopenia in this study followed by megaloblastic anaemia and hypersplenism being second and third common causes respectively. Pancytopenia should be suspected on clinical grounds when a patient presents with unexplained anemia, prolonged fever and tendency to bleed.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 157-161


2021 ◽  
pp. 35-38
Author(s):  
Anjali Sharma ◽  
Anand Deshpande ◽  
Chhavi Sauparna ◽  
Zeeshan Ahmed

Background: In India most cases of Megaloblastic anemia are caused by nutritional deciency of vitamin B12 and Folic acid. Initial workup include Complete Blood Count(CBC), Peripheral blood smear(PBS) ,Vitamin B12 asssay, folic acid assay and Bone marrow if required. Therefore, this study is planned to study the clinical and laboratory prole of children with Megaloblastic anemia and to study the clinical outcome of children with Megaloblastic anemia Methods: The study was a prospective observational study conducted among 60 children with megaloblastic anemia, aged 1- 12 years. Demographic data, clinical symptoms and signs, laboratory ndings, serum B12 and Folic acid ,Bone marrow report and stool routine microscopy report were collected. Chi square test was applied. Results: Among the 60 children 40% were female sand 60% were males. The age of the study population ranged from a minimum of 1 month to a maximum of 12 years with a mean(SD) of 8.08 (± 5.45).Majority of children (41.6%) were in age group of 6 months- 1 year. Most common symptoms fever and most common sign is pallor. More than fty percent cases presented with severe anemia. Many cases reported late, leading to delay in diagnosis leads to poor outcome. Developmental delay (neurological manifestation) is strongly associated with vitamin B 12 deciency as compared to folic acid deciency. (p value <0.05) Conclusions: There is a slight female preponderance seen in megaloblastic anemia, probably due to reduced attention to girl children in the study group. neurological manifestation is strongly associated with vitamin B 12 deciency as compared to folic acid deciency.


2021 ◽  
pp. 6-7
Author(s):  
Rachana Rachana ◽  
Nivedita Singh ◽  
Om Prakash Diwedi

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.


2015 ◽  
Vol 5 (9) ◽  
pp. 691-695
Author(s):  
S Vaidya

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


2021 ◽  
pp. 69-71
Author(s):  
Sonali Smita Xess ◽  
Vaishali Anand

Introduction: Anemia is one of the most commonly diagnosed conditions in a health care set up. Iron deciency anemia is the predominant cause of anemia across countries and in both sexes (1,2) . Although, in approximately 2 to 4 % of patients, laboratory evidence of macrocytosis is found (3) .The cause of macrocytic anemia is classied into megaloblastic or non-megaloblastic (4). Common causes of macrocytosis are different by region and setting. The present study aims at studying patients admitted in Civil Hospital Ahmedabad during the study period with MCV value more than 100 fL and utilizing the clinical prole and other biochemical parameters to further classify anemia into Megaloblastic and NonMegaloblastic type. The study period is January 1, 2018 to July 31, 2019. Relevant medical Materials and Methods: history of the patients participating in the study was considered. MCV value was determined from complete hemogram which was performed using Automatic Hematological Analyser. Peripheral smear examination was done with slides stained in Giemsa stain. Biochemical tests were performed using Automated Biochemistry Analysers. The data obtained from the above was then utilized in establishing the incidence of various causes of macrocytic anemia in our study population. Result: Out of the total 325 patients 160 (49%) were found to have megaloblastic anemia and 128 patients (40%) were found to have non-megaloblastic anemia. In the remaining 37 (11%) patients, no cause of macrocytosis was identied. The etiologies of macrocytic anemia identied in the present study were Vitamin B12 deciency, hepatic dysfunction, hypothyroidism, renal dysfunction and accelerated erythropoiesis (due to hemolysis or blood loss). Conclusion: The most common cause of macrocytic anemia in our study population was found to be Megaloblastic anemia.


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