Etiological Profile of Pancytopenia.

Introduction: Pancytopenia is a relatively common haematological entity. It is a striking feature of many serious and life threatening illnesses ranging from simple drug induced bone marrow hypoplasia, megaloblastic marrow to fatal bone marrow aplasias and leukemias. The severity of pancytopenia and the underlying pathology determines the management and prognosis. Thus, identification of the correct cause will help in implementing appropriate therapy. Objectives : • To find out the incidence of pancytopenia in the clinical pathological setup. • To find out the various causes of pancytopenia. • To study the clinicopathological correlation • To analyse the levels of vital hematological parameters during presentation. Methods : This is a prospective study to evaluate patients with pancytopenia. 50 patients of age group between 2 to 60 years presenting with cytopenias were evaluated in Hematology unit, Department of Pathology, Coimbatore Medical College, Coimbatore during period of March 2010 to August 2011.Patients on myelotoxic chemotherapy were excluded. Results : Among 50 cases studied, age of patients ranged from 5-60 years with a mean age of 39.5 years, and female predominance M:F was 1:1.2. Most of the patients presented with generalised weakness and fever. Commonest physical finding was pallor followed by hepatomegaly and splenomegaly. Dimorphic anaemia was predominant blood picture. Bone marrow aspiration was conclusive in all cases. Commonest marrow finding was hypercellularity with megaloblastic erythropoiesis. The commonest cause for pancytopenia was megaloblastic anaemia (68%) followed by aplastic anaemia (14%), myelofibrosis (12%),subleukemic leukemia (4%), myelodysplastic syndrome(2%).The commonest association was with Grade 2 marrowfibrosis in reticulin stain. Conclusion: Pancytopenia should be suspected on clinical grounds when a patient presents with unexplained anaemia, prolonged fever and tendency to bleed. Hence, present study concludes that detailed primary haematological investigations along with bone marrow aspiration in cytopenic patients is helpful for understanding disease process, to diagnose or to rule out the causes of cytopenia. As a large proportion of pancytopenia is of reversible aetiology, early and accurate diagnosis may be life-saving