Etiological Profile of Pancytopenia

Objectives-

1. To determine the common etiological causes of pancytopenia in Medical ICU and Wards of Gandhi Hospital Secunderabad.

2. To determine if critical analysis of peripheral smear provide clue to underlying etiology.

3. To evaluate hematological parameters including Bone Marrow Aspiration.

Methods:30 patients admitted into medical Icu and various wardsin Gandhi Hospital with following indices on hemogram, Hemoglobin<13.5gm%in males and Hb<11.5gm%in females,total leucocyte count<4000/cubic millimeter and platelet count<1,50,000/cubicmillimeter. Patients were subjected to detailed history including dietary habits ,physical examination was done.Biochemical parameters, Hemogramand Bonemarrow Aspiration were  done.

Results- Out of 30 patients studied 17 are male and 13 are female.16 patients(53%) were megloblastic,3 patients(10%)had aplastic anemia ,2(6.6%) had acute promyelocytic leukemia,2(6.6%)had acute lymphoblastic leukemia,1(3%)had myelodysplastic syndrome,1(3%) had Hodgkin’s lymphoma, 1(3%) had non Hodgkin’s lymphoma,1 patient(3%) had HIV induced pancytopenia,1(3%) had hyper splenism, peritonitis occurred in 1 patient(3%) and 1 patient(3%) had Systemic Lupus Erythematosis with pancytopenia.

Conclusions- Nutritional Megaloblastic with concurrent iron deficiency is the commonest cause of pancytopenia in this studyas indicated by macrocytes and hypersegmented neutrophils on peripheral smear. Acute leukemias and Aplastic anemias are the conditions with pancytopenia where bone marrow exam revealed diagnosis.