Etiological and Clinical Spectrum of Pancytopenia Based on Peripheral Blood Smear and Bone Marrow Examination: A Cross-sectional Study

Abstract

Aims: Pancytopenia is a common clinic-haematological problem suspected in patients with anaemia, prolonged fever, and a bleeding tendency.  This study was performed to find the prevalence of pancytopenia and to determine the common causes of pancytopenia. Study Design:  Cross-sectional observational study. Place and Duration of Study: department of general medicine at R. D. Gardi Medical College, Ujjain, India between November 2017 toAugust 2019. Methodology: The study was conducted among patients with pancytopenia during a two-year period. The etiological pattern was assessed through routine blood tests to determine their clinical features, peripheral blood pictures, and bone marrow morphologies. Results: Out of 100 patients with pancytopenia, the majority (64.0%) were men. A total of 34 patients were aged between the 21 and 30 years and 28 were aged between 31 and 40 years. Generalized weakness was the most common (88%) presentation and the most common clinical finding was pallor (94.0%), followed by splenomegaly (40.0%) and hepatomegaly (30.0%). Megaloblastic anaemia was the most common cause of pancytopenia that was observed in 58 patients, followed by aplastic anaemia (n=12), cirrhosis of the liver (n=8), leukaemia (n=6), dengue, myelodysplastic syndrome, and malaria (n=4 each), paroxysmal nocturnal haemoglobinuria and acquired immunodeficiency syndrome (n=2 each). A total of 28.0% patients had normocellular bone marrow and 72.0% had cellular marrow. Conclusion: Megaloblastic anaemia was the most common aetiology of pancytopenia.