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Year 2019

Volume: 6 , Issue: 3

Print ISSN:-2394-6784

Online ISSN:-2394-6792

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Indian Journal of Pathology and Oncology


A clinico-hematological study of pancytopenia: An experience of a tertiary care teaching hospital, Jammu, India


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Author Details: Neha Sharma, Puneet K. Bhatia, KK Kaul, Sonam Sharma, Manisha Sharma

Volume : 4

Issue : 4

Online ISSN : 2394-6792

Print ISSN : 2394-6784

Article First Page : 632

Article End Page : 637


Abstract

Introduction: Pancytopenia is not a disease entity but a triad of findings that may result from a number of disease processes and is defined as simultaneous presence of anaemia, leucopenia and thrombocytopenia. Bone marrow aspiration along with trephine biopsy is important to find out the cause of pancytopenia. The present study was essentially a pilot study which was undertaken over a period of 2 years at a tertiary care teaching hospital. The aims and objectives of this study was to find out the epidemiological spectrum and prevalence of pancytopenia according to age and sex along with the correlation of the clinical, haematological and bone marrow findings of such patients. An attempt was also made to determine the etiopathogenesis of pancytopenia for ascertaining the individual pathological pattern (spectrum).
Materials and Method: The present study was conducted in the Postgraduate Department of Pathology, Government Medical College and Associated Hospitals, Jammu, India over a period of 2 years. A total of 100 patients were prospectively analyzed and were subjected to bone marrow examination.
Results: The prevalence of pancytopenia in our haematological set-up was observed to be 0.76%. Pancytopenia was seen to be more prevalent in males (62%) in comparison to females (38%) with male to female ratio of 1.64:1. In the present study, majority of cases were diagnosed as megaloblastic anemia (60%) followed by subleukemic acute lymphoblastic leukemia (11%), subleukemic acute myeloblastic leukaemia (4%) and Kala azar (3%). Myelopthisic due to metastatic carcinomatous deposits was the least common etiological factor accounting for one case only.
Conclusion: Detailed examination of peripheral smear reveals important information regarding etiology e.g. macro-ovalocytes with hypersegmented neutrophils in megaloblastic anemia, occasional blast cell in subleukemic leukemia, absence of any abnormal/immature cell in aplastic anemia, leucoerythroblastic picture in myelofibrosis, pelgeroid neutrophils in MDS and nRBC with abnormal cells in metastatic malignancies. However, the diagnostic accuracy is increased manifolds when detailed clinical history and examination are combined with complete blood counts and peripheral smear evaluation. Although, bone marrow study (bone marrow aspiration/bone marrow trephine biopsy) provides the definite diagnosis in cases of pancytopenia.

Keywords:
Pancytopenia, Peripheral smear, Bone marrow, Spectrum, Etiology