Clinico-hematological study of pancytopenia: A single-center experience from north Himalayan region of India

Etiological spectrum of pancytopenia in adults based on hematological parameters and bone marrow studies

BACKGROUND

This study aimed to investigate the demographic, clinical, and diagnostic aspects of adult pancytopenia while exploring its etiological spectrum through hematological parameters and bone marrow studies.

RESEARCH DESIGN AND METHODS

This observational study involved 117 adult individuals ranging from 13 to 85 years who presented with pancytopenia. A comprehensive examination of demographic features, hematological parameters, clinical presentations, and physical findings, including liver and spleen characteristics, was conducted. Additionally, serological analyses for HBsAg and Anti HCV were performed. The diagnostic spectrum was determined through bone marrow studies.

RESULTS

Pancytopenia manifested with varied clinical symptoms, with generalized weakness (72.65%), fever (64.1%), dyspnea (54.70%), bleeding (34.2%), and weight loss (25.6%) being prominent. Physical examination revealed a range of liver and spleen characteristics, with hepatomegaly observed in 32.48% and splenomegaly in 44.4% of cases. Serological findings indicated HBsAg positivity in 8.5% and Anti HCV positivity in 21.37% of cases. The diagnostic distribution encompassed diverse conditions, with aplastic anemia (17.1%), megaloblastic anemia (12.8%), and myelodysplastic syndromes (12.8%) being prevalent.

CONCLUSIONS

This study provides a comprehensive overview of the demographic, clinical, and diagnostic aspects of pancytopenia. The observed prevalence of different diagnoses underscores the necessity of a thorough evaluation, including bone marrow studies, for accurate diagnosis and appropriate management.

Spectrum of Pancytopenia in Adults Attending a Clinical Hematology Department: A Four-Year Experience From a Tertiary Care Center of Western India

Background

Pancytopenia is a common hematological condition encountered in clinical practice. Because there is a wide variation in causes of pancytopenia even in different populations of the same geographical region, identifying the pattern of underlying etiologies is crucial for proper management. This study was conducted to evaluate the clinico-hematological profile and different etiologies of pancytopenia among adults presenting to a clinical hematology department at a tertiary care hospital of Western India.

Methodology

This observational study was conducted over a period of four years on 546 adult patients aged 18-93 years presenting with pancytopenia. After obtaining a detailed clinical history and physical examination, all participants were subjected to relevant investigations including bone marrow examination.

Results

A slight male preponderance was observed, and the most common age group (24%) was 21-30 years. Pallor was the most common clinical feature, followed by generalized weakness and fever. The most common cause of pancytopenia was acute leukemia (17.9%), followed by megaloblastic anemia (15.4%), aplastic anemia (11.0%), hypersplenism (7.8%), multiple myeloma (6.6%), and myelodysplastic syndrome (5.3%).

Conclusions

Acute leukemia was observed to be the most common cause of pancytopenia in this study, which is in contrast to various other studies from India conducted in different departments. Identification of etiologies of pancytopenia among patients attending hematology departments in various regions is expected to be useful in formulating diagnostic algorithms and management strategies, which can help clinicians to better manage such patients.

Hemorrhagic manifestation in different etiologies of pancytopenia: A prospective, cross-sectional study

Background

Pancytopenia is a triage of anemia, leukopenia, and thrombocytopenia. The etiology causing pancytopenia varies depending upon factors such as age, sex, occupation, and geographical distribution. Unfortunately, the major treatises of hematology have not given emphasis on the hemorrhagic manifestation of different etiologies causing pancytopenia.

Objective

This observational study was carried out with the aim to identify hemorrhagic manifestation in patients with pancytopenia in eastern India.

Design

This study was conducted over a period of two years at the Department of Medicine of a tertiary care teaching institute in eastern India. All the patients with features of anemia, thrombocytopenia, or leukopenia were screened for pancytopenia and a total of 214 cases were selected. Patients were divided into two groups as patients with age more than 14 years constitute group one and the patients less than 14 years constitute the second group. A detailed physical examination, hematological, and biochemical investigation was done to ascertain the hemorrhagic manifestations in pancytopenia patients.

Results

In the groups, the most common cause of hemorrhagic manifestation in patients with pancytopenia was aplastic anemic, leukemia, myelodysplastic syndrome, and myelofibrosis. No bleeding manifestation was seen in patients with megaloblastic anemia, kala-azar, hypersplenism, and other causes of pancytopenia.

Conclusions

Patients with pancytopenia caused by aplastic anemia, acute leukemia, and myelodysplastic syndrome have more chances of bleeding manifestation as compared with pancytopenia caused by megaloblastic anemia, kala-azar, or hypersplenism.