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Patterns of pancytopenia patients in a general medical ward and a proposed diagnostic approach.
J Ayub Med Coll Abbottabad. 2004 Jan-Mar; 16(1):8-13.JA

Abstract

BACKGROUND

There has been little systematic study on the clinical spectrum of pancytopenia. This study was done to describe the etiology, presentation and outcome of patients with pancytopenia presenting in a general medical ward.

METHODS

Hundred patients with pancytopenia were included in the study from October 2001 to October 2002. Patients on cancer chemotherapy were excluded. Blood counts, bone marrow examinations and trephine biopsies were performed according to standard methods.

RESULTS

In all cases, megaloblastic anemia constituted the largest group (n = 39), and also seen in conjunction with hemolytic anemia and septicemia. Hypersplenism secondary to portal hypertension (cirrhosis) was the second most common diagnosis (n = 19). Aplastic anemia, septicemia and myelodysplasia were other common causes. Two patients were the suspected cases of viral hemorrhagic fever. Thirteen (13%) patients expired. Absolute neutrophil count (ANC) less than 500/microliter was seen in 14 (14%) patients, among which 6 (15.3%) had megaloblastic anemia, 3 (37.5%) had aplastic anemia, and 2 (40%) had myelodysplasia. Eleven patients with platelet counts < or = 10 x 10(9)/L, 6 (54.5%) presented with bleeding; and 2 of these 8 had aplastic anemia and 1 patient with megaloblastic anemia. MCV values > 100 fL and > 110 fL were more frequent in patients with megaloblastic anemia with most prominent anisopoikilocytosis, microcytosis and fragmented RBCs. Macrocytosis was noted in 35 (89.7%) patients with megaloblastic anemia and 12 (63.1%) with hypersplenism, 4 (50%) with aplastic anemia. Hypersegmented neutrophils were noted in the blood films of 36 (92.3%) patients with megaloblastic anemia.

CONCLUSION

Megaloblastic anemia, hypersplenism and aplastic anemia are the common causes of pancytopenia in our study.

Authors+Show Affiliations

Ishtiaq O
Medical Unit II, Holy Family Hospital, Rawalpindi. osama@pakmedinet.com
Baqai HZ
No affiliation info available
Anwer F
No affiliation info available
Hussain N
No affiliation info available

MeSH

AdolescentAdultAgedAged, 80 and overAnemia, AplasticAnemia, MegaloblasticChildFemaleHumansHypersplenismMaleMiddle AgedPancytopenia

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15125172

Citation

Ishtiaq, Osama, et al. "Patterns of Pancytopenia Patients in a General Medical Ward and a Proposed Diagnostic Approach." Journal of Ayub Medical College, Abbottabad : JAMC, vol. 16, no. 1, 2004, pp. 8-13.
Ishtiaq O, Baqai HZ, Anwer F, et al. Patterns of pancytopenia patients in a general medical ward and a proposed diagnostic approach. J Ayub Med Coll Abbottabad. 2004;16(1):8-13.
Ishtiaq, O., Baqai, H. Z., Anwer, F., & Hussain, N. (2004). Patterns of pancytopenia patients in a general medical ward and a proposed diagnostic approach. Journal of Ayub Medical College, Abbottabad : JAMC, 16(1), 8-13.
Ishtiaq O, et al. Patterns of Pancytopenia Patients in a General Medical Ward and a Proposed Diagnostic Approach. J Ayub Med Coll Abbottabad. 2004 Jan-Mar;16(1):8-13. PubMed PMID: 15125172.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patterns of pancytopenia patients in a general medical ward and a proposed diagnostic approach. AU - Ishtiaq,Osama, AU - Baqai,Haider Z, AU - Anwer,Faiz, AU - Hussain,Nisar, PY - 2004/5/6/pubmed PY - 2004/5/28/medline PY - 2004/5/6/entrez SP - 8 EP - 13 JF - Journal of Ayub Medical College, Abbottabad : JAMC JO - J Ayub Med Coll Abbottabad VL - 16 IS - 1 N2 - BACKGROUND: There has been little systematic study on the clinical spectrum of pancytopenia. This study was done to describe the etiology, presentation and outcome of patients with pancytopenia presenting in a general medical ward. METHODS: Hundred patients with pancytopenia were included in the study from October 2001 to October 2002. Patients on cancer chemotherapy were excluded. Blood counts, bone marrow examinations and trephine biopsies were performed according to standard methods. RESULTS: In all cases, megaloblastic anemia constituted the largest group (n = 39), and also seen in conjunction with hemolytic anemia and septicemia. Hypersplenism secondary to portal hypertension (cirrhosis) was the second most common diagnosis (n = 19). Aplastic anemia, septicemia and myelodysplasia were other common causes. Two patients were the suspected cases of viral hemorrhagic fever. Thirteen (13%) patients expired. Absolute neutrophil count (ANC) less than 500/microliter was seen in 14 (14%) patients, among which 6 (15.3%) had megaloblastic anemia, 3 (37.5%) had aplastic anemia, and 2 (40%) had myelodysplasia. Eleven patients with platelet counts < or = 10 x 10(9)/L, 6 (54.5%) presented with bleeding; and 2 of these 8 had aplastic anemia and 1 patient with megaloblastic anemia. MCV values > 100 fL and > 110 fL were more frequent in patients with megaloblastic anemia with most prominent anisopoikilocytosis, microcytosis and fragmented RBCs. Macrocytosis was noted in 35 (89.7%) patients with megaloblastic anemia and 12 (63.1%) with hypersplenism, 4 (50%) with aplastic anemia. Hypersegmented neutrophils were noted in the blood films of 36 (92.3%) patients with megaloblastic anemia. CONCLUSION: Megaloblastic anemia, hypersplenism and aplastic anemia are the common causes of pancytopenia in our study. SN - 1025-9589 UR - https://www.unboundmedicine.com/medline/citation/15125172/Patterns_of_pancytopenia_patients_in_a_general_medical_ward_and_a_proposed_diagnostic_approach_ DB - PRIME DP - Unbound Medicine ER -