Etiological Spectrum and Clinical Profile of Patients Admitted with Pancytopenia

Aims: The etiological spectrum and clinical profile of admitted patients presenting with pancytopenia were studied.

Study Design: This was a prospective study conducted on 200 patients presenting to the Department of Medicine, Department of Oncology and the Allied Specialities of Medicine, Dayan and Medical College and Hospital, Ludhiana and were found to have pancytopenia during hospital stay.

Results: Mean age of the patients was 45.69 ± 17.05 years with maximum number of patients (23%) in the age group of 51-60 years and 119 patients were males and 81 patients were females. Most common physical finding was pallor (95%), followed by splenomegaly (22%) and hepatomegaly (17%). Total of 107 patients were vegetarians (53.5%) and 93 patients (46.5%) were non-vegetarians. Mean hemoglobin was 7.16 ± 2.04 g/dl, mean total leucocyte count was 2.51 ± 1.02 x 103/cu. mm, mean platelet count was 54885.37 x 103/ul ± 40320.96 and mean the absolute neutrophil count was 1.59 x 103 /cu.mm ± 0.84. Ten patients of pancytopenia were because of tropical fever which included 4 cases of dengue, 3 cases of malaria, 2 cases of enteric fever and 1case of mixed infection (malaria + scrub typhus). Viral markers were positive in 14 out of the 63 patients tested. Out of these 14 patients, 4 were HBsAg reactive, 7 were HCV +ve and 3 were HIV +ve. Most common red blood cell picture on peripheral blood film was normocytic normochromic (34.5%), followed by mixed morphology (33.5%). Macrocytic and microcytic morphology was seen in 19.5% and 12.5% of the patients respectively. Hypercellular marrow was seen in 82 patients (42.9%), normocellular marrow was seen in 58 patients (30.3%) and hypocellular marrow was seen in 51 patients (26.7%). The most common cause of pancytopenia in this study was megaloblastic anemia in 59 patients (29.5%), the 2nd common cause was leukemias in 28 patients (14%) and the 3rd cause was aplastic anemia in 22 patients (11%). Drug induced pancytopenia was seen in 21 patients (10.5%) and hypersplenism in 9 cases (4.5%).

Conclusion: This study has helped us in knowing the various etiologies of pancytopeniain this hospital. Megaloblastic anemia was the most common etiology in this study followed by leukemiasand aplastic anemia. The study helped us in understanding of the age and gender distribution, the hematological parameters, the peripheral blood film in pancytopenia and the bone marrow picture in these patients.