ASSOCIATION OF MEGALOBLASTIC ANEMIA WITH PERIPHERAL CYTOPENIAS

Objective: To asses the association of megaloblastic anemia with peripheral cytopenias. Material and Methods: This analytical study was carried out in Department of Pathology, Lady Reading Hospital, Peshawar from July 2004 to June 2006. One hundred and three reports of bone marrow cytology with the diagnosis of megaloblastic anemia were collected. Peripheral blood reports of all these cases were assessed for the association of megaloblastic anemia with peripheral blood cytopenias. Patients with visceromegaly, obvious signs of hemolytic anemia and malignancy were excluded from the study. During the two years, 1024 patients underwent bone marrow aspiration. Out of these, 103 patients had megaloblastic anemia, which accounted for 10.05% of the hematological disorders that required bone marrow aspiration. Seventy three patients (70.87%) had pure megaloblastic anemia and 30 patients (29.12%) had megaloblastic anemia along with iron deficiency. The male to female ratio was 1.2:1. The main presenting features were those related to neutropenia (n=44), anemia (n=38) and thrombocytopenia (n=12). Results: Anemia was present in all the 103 patients (100%). Pancytopenia was present in 40 patients (38.8%). Bicytopenia having low hemoglobin (anemia) and low total leukocyte count (leucopenia) was found in 16 patients (15.53%) while bicytopenia having low hemoglobin and low platelets (thrombocytopenia) were found in 14 patients (13.5%). Low hemoglobin alone was found in 12 patients (11.65%). Conclusion: Megaloblastic anemia presents itself as anemia, bicytopenia and pancytopenia. The cytopenias are important feature of megaloblastic anemia and may present at any age.