scholarly journals Bone marrow evaluation of patients having pancytopenia at tertiary care center, M. Y. hospital, Indore, India: one-year study

Author(s):  
Meena Mittal ◽  
C.V. Kulkarni ◽  
Khushboo Likhar

Background: Pancytopenia is reduction of all three formed elements of blood below the normal reference range leading to anemia, leucopenia, thrombocytopenia. Bone marrow aspiration is extremely helpful in evaluating the cause of pancytopenia by cellularity and cytology in order to prevent grave complications and mortality as the underlying pathology determines the management and prognosis of the patients. Aim of research study was to evaluate the patients having pancytopenia at tertiary care center, M.Y.H. Hospital, Indore, India.Methods: The present study was carried out over a period of one year from 2017 to 2018, in the Department of Pathology, M. Y. Hospital, Indore. During this period, a total of 109 bone marrow smears were examined. Out of these, 42 cases had the clinical presentation of pancytopenia. A detailed study was done regarding clinical examination and hematological and radiological investigations.Results: In this study 42 cases of pancytopenia were examined over a period of one year. The commonest cause of pancytopenia was megaloblastic anemia (33.34%) followed by aplastic anemia (19.05%). Others includes myelodysplastic syndrome (MDS), acute leukemia, erythroid hyperplasia and plasmacytosis.Conclusions: Bone marrow aspiration can diagnose majority of the cases of pancytopenia. Megaloblastic anemia and aplastic anemia are the commonest causes of pancytopenia.

2018 ◽  
Vol 5 (4) ◽  
pp. 946
Author(s):  
Subuh Parvez Khan ◽  
Sajad Geelani ◽  
Fiza Parvez Khan ◽  
Noorjahan Ali ◽  
Shazieya Akhter ◽  
...  

Background: Pancytopenia refers to combination of anaemia, leukopenia and thrombocytopenia. It may be a manifestation of a wide variety of disorders, which primarily or secondarily affect the bone marrow. However, aetiology of pancytopenia varies from one geographical region to another. Bone marrow aspiration plays an important role in identifying the cause of pancytopenia. This study was carried to identify the causes of pancytopenia and to find out the bone marrow morphology in cases of pancytopenia.Methods: This study was conducted in the department of haematology in a tertiary care center in Kashmir valley for a period of 3 years. Inclusion criteria: cases with hemoglobin less than 10 gm/dl, total leucocyte count of less than 4000/mm3 and platelet count less than 100,000/mm3 were included in the study.Exclusion criteria: Patients receiving chemotherapy/radiotherapy were excluded from the study. Bone marrow aspiration (BMA) was performed from posterior iliac crest of the patients. Bone marrow aspiration smears were stained with Leishman stain for microscopy.Results: A total of 334 cases were studied during a period of 3 years. Age of patients ranged from 1 year to 85 years with mean of 43.59 years.180 cases were male, and 154 cases were female with male:female ratio of 1.2 :1. The commonest cause of pancytopenia was megaloblastic anemia seen in 103 cases (30.8%) followed by dual deficiency anemia seen in 69 cases (20.7%).37 cases (11%) were of acute leukaemia. Aplastic anemia was seen in 35 cases(10.5%). Other causes of pancytopenia were myelodysplastic syndrome, multiple myeloma, iron deficiency anemia and hypersplenism.Conclusions: Bone marrow aspiration in patients of pancytopenia helps in the identification of the underlying cause in most of the cases. BMA is helpful for understanding the disease process; and in planning further investigations and management of cytopenia patients. 


2019 ◽  
Vol 10 (4) ◽  
pp. 2927-2935
Author(s):  
Saurabh Chopra ◽  
Lalit Prashant Meena ◽  
Jaya Chakravarty ◽  
Madhukar Rai

Megaloblastic anemia and Myelodysplastic syndrome are generally considered mutually exclusive diagnosis and at times becomes difficult to diagnose on the first encounter even after performing bone marrow examination. Aim of this study is to evaluate the role of LDH in the diagnosis of Megaloblastic anemia by treatment response at a tertiary care center in the northeastern part of India. Patients with age more than 12 years, Hemoglobin of patients less than 10 gm/dl, MCV ≥ 100 fl, Reticulocyte count <2.5 were included in the study. Based on serum LDH level patients were divided into two groups. Group A with serum LDH level ≥ 1200 U/L and Group B with serum LDH level of less than 1200 U/L. All these patients of serum LDH ≥1200 U/L were given a treatment trial of injectable Vitamin B12 containing 1000 μg of Vitamin B12 for 14 days. The response to treatment was monitored by an increment in reticulocyte count at day 5 and day 14. Bone marrow aspiration was done in all patients who had serum LDH less than 1200 mg/dl. Seventy-nine consecutive patients, who presented with anemia (Hb<10 g/dl) and macrocytosis (MCV > 100 fl) were included in the study. Median LDH values were higher in the patients who responded ( vitamin B12 deficient megaloblastic anemia ) as compared to non-responders. 93.5% of patients with megaloblastic anemia had Vitamin B12 deficiency, and in comparison, the folic acid deficiency was present among just 6.5 percent patients. Serum Vitamin B 12 and Folic acid level should not be used as a sole criterion for the diagnosis of Megaloblastic anemia and other parameters such as MCV, LDH, and characteristic blood picture, should all be taken into consideration before planning an appropriate treatment strategy.


2015 ◽  
Vol 5 (9) ◽  
pp. 691-695
Author(s):  
S Vaidya

Background: A spectrum of primary and secondary disorders that affect the bone marrow may manifestwith pancytopenia. This study was carried out to identify the various causes of pancytopenia in patients attending a tertiary care hospital in Lalitpur, Nepal.Materials and Methods: A descriptive study of 83 cases of pancytopenia was carried out in the Department of Pathology, Patan Academy of Health Sciences, Lalitpur, Nepal over a two year period from August 2010 to July 2012.Results: Eighty three patients underwent bone marrow examination. Mean age of the patients was 34 years (range: 4 to 75 years). Maximum number of patients (31.33%) was seen in the age group of 16 - 30 years. The commonest cause of pancytopenia was megaloblastic anemia which was seen in 34.94% (29/83) cases followed by aplastic anemia and hematological malignancies in 31.32% (26/83) and 14.46% (12/83) cases, respectively.Conclusion: This study concluded that megaloblastic anemia and aplastic anemia were the two most common causes of pancytopenia. Bone marrow aspiration is an established diagnostic modality in the evaluation of pancytopenia.Journal of Pathology of Nepal (2015) Vol. 5, 691 - 695


Author(s):  
Pinal Shah ◽  
R. D. Patel ◽  
Bhavna Gamit ◽  
Shruti Gheewala

Background: Pancytopenia is a relatively common hematological entity. This study was undertaken to find out the various causes of pancytopenia by bone marrow examination of patients admitted to New civil hospital, Surat, Gujarat, India.Methods: This was a prospective study carried out to identify the causes of pancytopenia based on bone marrow examination. Bone marrow examinations were performed in 144 cases for different indications over a period of one year 2015, out of which 40 cases have fulfilled the criteria of pancytopenia.Results: Total 40 cases of pancytopenia were examined during period of one year. The commonest cause of pancytopenia was megaloblastic anemia (35%) followed by aplastic anemia (32.5%). other cause includes acute leukemia, myelodysplastic syndrome (MDS) and round cell tumor.Conclusions: Bone marrow aspiration coupled with trephine biopsy can diagnosed majority cases of pancytopenia. Megaloblastic anemia and aplastic anemia are the commonest causes of pancytopenia. A comprehensive clinical and hematological study of patients with pancytopenia will help in the identification of underlying cause.


2020 ◽  
Vol 40 (4) ◽  
pp. 298-304
Author(s):  
Khalid A. Alsheikh ◽  
Firas M. Alsebayel ◽  
Faisal Abdulmohsen Alsudairy ◽  
Abdullah Alzahrani ◽  
Ali Alshehri ◽  
...  

ABSTRACT BACKGROUND: Hip fractures are one of the leading causes of disability and dependency among the elderly. The rate of hip fractures has been progressively increasing due to the continuing increase in average life expectancy. Surgical intervention is the mainstay of treatment, but with an increasing prevalence of comorbid conditions and decreased functional capacity in elderly patients, more patients are prone to postoperative complications. OBJECTIVES: Assess the value of surgical intervention for hip fractures among the elderly by quantifying the 1-year mortality rate and assessing factors associated with mortality. DESIGN: Medical record review. SETTING: Tertiary care center. PATIENTS AND METHODS: All patients 60 years of age or older who sustained a hip fracture between the period of 2008 to 2018 in a single tertiary healthcare center. Data was obtained from case files, using both electronic and paper files. MAIN OUTCOME MEASURES: The 1-year mortality rate for hip fracture, postoperative complications and factors associated with mortality. SAMPLE SIZE: 802 patients. RESULTS: The majority of patients underwent surgical intervention (93%). Intra- and postoperative complications were 3% and 16%, respectively. Four percent of the sample died within 30 days, and 11% died within one year. In a multivariate analysis, an increased risk of 1-year mortality was associated with neck of femur fractures and postoperative complications ( P =.034, <.001, respectively) CONCLUSION: The 1-year mortality risk in our study reinforces the importance of aggressive surgical intervention for hip fractures. LIMITATION: Single-centered study. CONFLICT OF INTEREST: None.


Author(s):  
Seema Meena ◽  
Sukriti . ◽  
Sonal Bhati ◽  
Abha Patni

Background: Bone marrow aspiration (BMA) is a minimally invasive technique performed in a variety of hematological disorders. It is considered essential for the diagnosis and management of haematological disorders. BMA is usually sufficient to diagnose nutritional anemia and most of the leukemias. Aims & Objectives: To study the spectrum of hematological disorders diagnosed on BMA in a tertiary care centre, Udaipur. Material & Methods:  The present study was conducted in the hematology section of department of Pathology, RNT Medical College & MB Hospital, Udaipur for a period of one year from June 2018 to May 2019. A total of 123 cases of suspected hematological disorders underwent the process of BMA from posterior superior iliac spine under local anesthesia. Exclusion criteria of our study included aspirates of dry tap. BMA smears were stained with Giemsa stain for morphologic examination. Result: The present study included 123 cases. Male to female ratio in our study was 1.6:1. Anemia (45.5%) was the most common hematological disorder in our study, iron deficiency anemia being the most common followed by megaloblastic anemia. Chronic myeloid leukemia (26.01%) was the most common hematological malignancy in our study. Conclusion: Bone marrow aspiration is a useful diagnostic procedure in hematological practice for the diagnosis of both hematological and non-hematological conditions. Rapid and early diagnosis of malignancies are critical for proper initiation of treatment and to control the disease. Keywords: Bone Marrow Aspiration, Hematological disorders, Leukemias


2021 ◽  
Vol 6 (3) ◽  
pp. 201-206
Author(s):  
Kavya J ◽  
Kalpana Kumari MK

Pancytopenia is commonly reported in clinical hematology practice. Due to its varied marrow pathology and underlying ailments, diagnosis is often misleading and delayed. Bone marrow examination would provide a comprehensive diagnosis of both blood and bone marrow, since aspirate investigates the cytological morphology and biopsy evaluates the cellularity, architecture, and compact marrows.To compare bone marrow aspiration and trephine biopsy results in the diagnosis of pancytopenia, and to determine the sensitivity and specificity of aspirate examination in pancytopenia diagnosis.This prospective study was conducted at a tertiary care hospital from July 2014 to June 2016. A total of 320 samples were received at the department of pathology for bone marrow examination (aspirate and biopsy). Romanowsky (Leishman) stain was used to investigate aspirate samples. All biopsy samples were processed into 3-5 μ blocks and stained using hematoxylin and eosin after decalcification with 5.5% EDTA. Data analysis was performed using SPSS19.Pancytopenia constituted 56 (18.7%) cases with the mean age of 41.79 years. Of the total pancytopenia cases, hematological disorders constituted 50 (89.3%) cases and 6 (10.7%) were non-hematological cases. Aspirate and biopsy diagnosis positively correlated in 76.79% of cases. A 100% sensitivity and specificity of aspirate diagnosis was observed in, acute myeloid leukemia, hypersplenism, myelodysplastic syndrome, megaloblastic anemia, hematological malignancy in remission and negative for lymphoma infiltrate. Aspirate had no role in diagnosis of uremic osteodystrophy and myelofibrosis, whereas leishmaniasis was diagnosed on aspirate alone.Pancytopenia includes multiple underlying ailments which requires a differential diagnosis approach. Combining both aspirate and biopsy for diagnosis would benefit the patient in prognosis as they are complementary to each other.


Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1589 ◽  
Author(s):  
Erkka Tommola ◽  
Satu Tommola ◽  
Sinikka Porre ◽  
Ivana Kholová

The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced in 2018 following other organ specific cytopathological reporting systems and it aimed at bringing a practical, evidence-based, user-friendly classification system with characterization and management algorithms. At the Department of Pathology, Fimlab Laboratories, Tampere, Finland all salivary fine needle aspirations (FNAs) have been given cytopathological diagnoses according to the MSRSGC since January 2018. Analyses of a one-year-period (January 2018–December 2018) consisted of 183 salivary FNA samples from 138 patients with correlation to histopathology in 90 cases with surgical follow-up. The MSRSGC performance in patient based analysis was as follows: accuracy was 90.9%, sensitivity was 61.5%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 89.4%, respectively. Risks of malignancy (ROMs) in MSRSGC categories were: 0.0% (0/15) in non-diagnostic category, 100.0% (1/1) in non-neoplastic category biased by only one falsely-negative lymphoma case, 14.3% (1/7) in atypia of undetermined significance category, 0.0% (0/28) in benign neoplasm category, 27.3% (3/11) in neoplasm of uncertain malignant potential category, and 100% for both suspicious for malignancy (4/4) and malignancy (4/4) categories, respectively. The MSRSGC has been proven as a reliable classification system in salivary gland FNA routine diagnostics in a tertiary care center.


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