Clinical and Etiological profile of Pancytopenia in a Tertiary Care Hospital

BACKGROUND AND OBJECTIVES: Pancytopenia means a disorder in which all three blood elements (RBCs, WBCs and platelets) are decreased than normal although it is a common clinical problem with an extensive differential diagnosis, there is a relatively little discussion of this abnormality. Detailed work up is generally required for total evaluation of such case. The objective of the present study was to determine various clinical presentations and etiological factors of pancytopenia. METHODS: The present cross sectional study was conducted in Department of Medicine, in Tirunelveli medical college and Hospital. The study was conducted with 50 patients admitted with pancytopenia with age > 15 years. Detailed history, clinical examination, blood investigations and bone marrow examination were performed. Other investigations like bone marrow trephine biopsy, serological tests, Chest X-ray were performed as necessary. RESULTS: In all cases, megaloblastic anemia constituted the largest group (42%) followed by aplastic anemia (14%), Myelodysplastic syndrome (10%), ALL (8%), AML and sepsis (6%), Disseminated tuberculosis (4%), Hypersplenism (4%), Malaria (4%) and Multiple Myeloma (2%). The most common symptom was easy fatigue (90%) followed by fever (54%) and giddiness (40%). Pallor (100%) and splenomegaly (38%) were the most common physical findings. CONCLUSION: Megaloblastic anemia and aplastic anemia were the most common causes of pancytopenia followed by Myelodysplastic syndrome and acute leukemia. Bone marrow study or trephine biopsy was helpful in most of the cases to find out the etiological cause.