A cross-sectional study of the clinical profile and aetiological spectrum of pancytopenia in a tertiary care centre

Santra G, Das BK
Correspondence: Dr Gouranga Santra, g.santra@yahoo.com

ABSTRACT
Introduction Pancytopenia is a common haematological problem. It is suspected when a patient presents with anaemia, prolonged fever and a bleeding tendency. Pancytopenia has multiple causes, but the frequency of these causes has been reported in a limited number of studies. The present study was conducted to assess the aetiological pattern, clinical profile and bone marrow morphology of pancytopenia patients.
Methods A total of 111 adult pancytopenia patients aged 13 to 65 years were studied during a one-year period to determine their clinical features, peripheral blood pictures and bone marrow morphologies. The aetiological pattern was assessed through the relevant investigations in the respective patients.
Results 45.95 percent of the pancytopenic patients had a hypocellular marrow, while 54.05 percent had normocellular or hypercellular marrow. Idiopathic aplastic anaemia (20.72 percent) was the commonest cause of pancytopenia, followed by hypersplenism due to chronic liver disease (11.71 percent). Other important causes were kala-azar (nine percent), megaloblastic anaemia, systemic lupus erythematosus (SLE), infections and drug inducement. Infections such as kala-azar, falciparum malaria and enteric fever, megaloblastic anaemia as well as SLE were found to be treatable and reversible causes of pancytopenia.
Conclusion As a large number of pancytopenic patients have a reversible aetiology, early and proper diagnosis may be life-saving.

Keywords: aplastic anaemia, bone marrow, hypersplenism, kala-azar, pancytopenia
Singapore Med J 2010; 51(10): 806-812