TO STUDY THE ETIOPATHOLOGICAL SPECTRUM OF ADULT PATIENTS WITH PANCYTOPENIA

2020 ◽  
Vol 4 (10) ◽  
Author(s):  
Harimohan Garg ◽  
Haritej Anand Khirawari ◽  
Sona Priyadarshi
Keyword(s):  
Acute Leukemia ◽  
Aplastic Anemia ◽  
Indian Subcontinent ◽  
Megaloblastic Anemia ◽  
Anaplastic Carcinoma ◽  
Adult Patients ◽  
Research Centre ◽  
New Delhi ◽  
Nutritional Anemia ◽  
Male Preponderance

Background: Pancytopenia is diagnosed when there is a reduction in all three hematopoietic cell lines. Till date there is limited number of studies on the frequency of various causes of pancytopenia. Of these some have been reported from the Indian subcontinent. There appears to be a changing spectrum of pancytopenia over the past two decades. The objective was to study the etiopathological spectrum of adult patients with pancytopenia over a period of one and half year. Methods: The Prospective and retrospective observational study was conducted in the Department of Family Medicine, Batra Hospital and Medical Research Centre, New Delhi.  A total of 120 Patients were included in the study. All patients gave their consent to take part in the study and were subjected to a questionnaire regarding symptoms, past relevant history, lifestyle and detailed clinical examination and investigations as mentioned in materials and methods. Results: Six broad diagnostic groups could be identified in adults with pancytopenia. Megaloblastic anemia (D1) was the largest group comprising 57.5% of all patients. 11.7% of patients with pancytopenia were diagnosed as Aplastic anemia (D2).11.7% of patients with pancytopenia were diagnosed as leukemia/lymphoma (D3) such as lymphoma (1), metastatic anaplastic carcinoma (1), acute leukemia (11), and metastatic gastric carcinoma (1). 15% of patients with pancytopenia were diagnosed with infections (D4) such as complicated malaria cases (7), HIV (5), disseminated tuberculosis (4), viral (2). We also encountered (D5) 0.8% was Myelophthisis/Storage disorder as myelodysplastic syndrome (1) and 3.3% were other (D6) as reactive marrow (4). Conclusion: Pancytopenia is not a disease itself. It is a hematological feature of varying etiology with slight male preponderance. Megaloblastic anemia along with mixed nutritional anemia is leading cause of pancytopenia in India followed by infections being second and aplastic anemia and acute leukemia being third common causes. Keyword: Pancytopenia, Megaloblastic anemia, Nutritional anemia.

scholarly journals Clinico hematological profile of pancytopenia in pediatric patients: an institutional experience in North Himalayan region of India

2020 ◽  
Vol 8 (2) ◽  
pp. 726
Author(s):  
Anil Rawat ◽  
Varun Mamgain ◽  
Smita Chandra ◽  
B. P. Kalra
Keyword(s):  
Bone Marrow ◽  
Aplastic Anemia ◽  
Megaloblastic Anemia ◽  
Nutritional Deficiency ◽  
Deficiency Anemia ◽  
Total Leukocyte Count ◽  
Mean Corpuscular Hemoglobin ◽  
Corpuscular Hemoglobin ◽  
Common Cause ◽  
Nutritional Anemia

Background: Pancytopenia is a common clinical pattern with an extensive differential diagnosis, but literature search shows only limited studies of pancytopenia in Pediatrics patients in Uttarakhand state of India. The present study was therefore conducted to study the spectrum of pancytopenia with bone marrow and haematological profile in Pediatrics patients in this north Himalayan state of India.Methods: Prospective observational study was conducted in the Department of Pediatrics in the teaching institute situated in Uttarakhand state of India over a period of 12 months. The study included all the patients of pancytopenia below 18 years of age who underwent bone marrow examination after written informed consent.Results: The study included total 50 pediatrics patients of pancytopenia with male to female ratio of 1.38:1. The mean age of patients was 10.58±4.94 with median age of 12 years. Mean hemoglobin was 5.31±2.09 g/dl, total leukocyte count was 2492.68±941.76/mm3, platelet count was 34724±26423/mm3, mean corpuscular volume was 90.95±16.65 fl, mean corpuscular hemoglobin was 30.11±6.07 pg, mean corpuscular hemoglobin concentration was 33.06±1.65% and reticulocyte count was 1.21±1.10%. Nutritional deficiency (28%) was the most common cause for pancytopenia followed by aplastic anemia (24%). Megaloblastic anemia was the commonest cause of nutritional deficiency anemia (71.42%) with pancytopenia.Conclusions: Pancytopenia is an important presentation in Pediatrics population with the most common cause being nutritional anemia and aplastic anemia. Megaloblastic anemia is the commonest cause of nutritional anemia with pancytopenia. The clinicians should be aware of spectrum of pancytopenia with clinical and haematological presentation in Pediatrics patients of this region so as to avoid unnecessary work ups and delay in treatment.

scholarly journals Drug-Induced Hematologic Syndromes

2009 ◽  
Vol 2009 ◽  
pp. 1-11 ◽  
Author(s):  
David M. Mintzer ◽  
Shira N. Billet ◽  
Lauren Chmielewski
Keyword(s):  
Side Effects ◽  
Acute Leukemia ◽  
Aplastic Anemia ◽  
Immune Thrombocytopenia ◽  
Megaloblastic Anemia ◽  
Coagulation System ◽  
Red Cell ◽  
Sideroblastic Anemia ◽  
Drug Induced ◽  
Hematologic Disorders

Objective. Drugs can induce almost the entire spectrum of hematologic disorders, affecting white cells, red cells, platelets, and the coagulation system. This paper aims to emphasize the broad range of drug-induced hematological syndromes and to highlight some of the newer drugs and syndromes.Methods. Medline literature on drug-induced hematologic syndromes was reviewed. Most reports and reviews focus on individual drugs or cytopenias.Results. Drug-induced syndromes include hemolytic anemias, methemoglobinemia, red cell aplasia, sideroblastic anemia, megaloblastic anemia, polycythemia, aplastic anemia, leukocytosis, neutropenia, eosinophilia, immune thrombocytopenia, microangiopathic syndromes, hypercoagulability, hypoprothrombinemia, circulating anticoagulants, myelodysplasia, and acute leukemia. Some of the classic drugs known to cause hematologic abnormalities have been replaced by newer drugs, including biologics, accompanied by their own syndromes and unintended side effects.Conclusions. Drugs can induce toxicities spanning many hematologic syndromes, mediated by a variety of mechanisms. Physicians need to be alert to the potential for iatrogenic drug-induced hematologic complications.

scholarly journals Acute Appendicitis in Neutropenic Patients with Acute Leukemia

2010 ◽  
Vol 3 ◽  
pp. CMTIM.S4632
Author(s):  
K.A. Al-Anazi ◽  
A.M. Al-Jasser ◽  
N. Abu Daff ◽  
A. Al-Saghier ◽  
F. Zwan ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Acute Leukemia ◽  
Clinical Manifestations ◽  
Rare Event ◽  
Armed Forces ◽  
Infectious Complications ◽  
Adult Patients ◽  
Research Centre ◽  
Control Group ◽  
Neutropenic Patients

Background In neutropenic patients with acute leukemia, acute abdomen which is usually attributed to typhlitis may be encountered. However, the diagnosis of acute appendicitis is rarely described or confirmed. Methods and Materials A retrospective study of acute appendicitis in adult patients with acute leukemia was conducted at the Riyadh Armed Forces Hospital between January 1991 and December 2002 and then the study was continued at King Faisal Specialist Hospital and Research Centre in Riyadh between January 2004 and December 2006. Results Acute appendicitis developed in three out of 408 patients with acute leukemia treated at both institutions. The incidence of acute appendicitis in adult patients with acute leukemia was 0.74%. Acute appendicitis was encountered during the neutropenic periods following the courses of cytotoxic chemotherapy given to control the leukemia. The three study patients were males and they presented with the classical clinical manifestations of acute appendicitis and they underwent successful appendicectomies. The radiological investigations were helpful in confirming the clinical diagnoses. Compared to the control group of patients, the study patients developed acute leukemia at a younger age and they also had higher rates of: infectious complications, relapse and mortality but lower rate of cytogenetic abnormalities and extramedullary disease. Conclusions The development of acute appendicitis in neutropenic patients with acute leukemia is an extremely rare event. The combination of the classical clinical manifestations as well as the compatible radiological features is essential diagnostically. Taking a decision to operate on these immunocompromised patients during the periods of severe pancytopenia is a real challenge to surgeons and hematologists. However, surgical intervention may be associated with long term complications such as relapse of the leukemia, infectious complications and decreased survival.

scholarly journals Bone marrow examination in cases of pancytopenia

2017 ◽  
Vol 5 (4) ◽  
pp. 1494 ◽  
Author(s):  
Pinal Shah ◽  
R. D. Patel ◽  
Bhavna Gamit ◽  
Shruti Gheewala
Keyword(s):  
Bone Marrow ◽  
Acute Leukemia ◽  
Aplastic Anemia ◽  
Megaloblastic Anemia ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Round Cell ◽  
Trephine Biopsy ◽  
One Year ◽  
A Prospective Study

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.

scholarly journals Prognostic factors in adult patients with acute leukemia at first relapse

Cancer ◽  
1987 ◽  
Vol 59 (9) ◽  
pp. 1631-1634 ◽  
Author(s):  
Paul Smits ◽  
Lia Schoots ◽  
Ben E. de Pauw ◽  
Theo de Witte ◽  
Rob S. G. Holdrinet ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Acute Leukemia ◽  
Adult Patients ◽  
First Relapse

scholarly journals A prospective clinico-etiological study of 100 cases of pancytopenia in a tertiary care hospital in Eastern India

2021 ◽  
Vol 11 (2) ◽  
pp. 236-240
Author(s):  
Palai Sabita ◽  
Swain Santosh Kumar ◽  
Nayak Rajeeb Kumar ◽  
Majhi Majha ◽  
Padhi Prabhat Kumar ◽  
...  
Keyword(s):  
Aplastic Anemia ◽  
Megaloblastic Anemia ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Macrocytic Anemia ◽  
General Medicine ◽  
Good Prognosis ◽  
Total Leucocyte Count ◽  
Care Hospital ◽  
Hematological And Biochemical Parameters

Pancytopenia is a hematological entity which is relatively common. Its evaluation is important for arriving at an early and correct diagnosis, to aid in appropriate management.It was an observational study conducted in the Department of General Medicine and Clinical Hematology of our institute from June 2019 to May 2020. Clinical, hematological and biochemical parameters of 100 pancytopenic patients were evaluated and descriptive statistics was used. The age ranged from 18-75 years. The commonest presentation was easy fatigability and fever. Besides pallor, splenomegaly and hepatomegaly were the presenting signs. Megaloblastic anaemia was detected in 64% followed by aplastic anaemia in 12% and acute leukemia in 6% patients. Among infective etiologies, two cases of malaria (P. falciparum). And each case of HIV, tuberculosis and dengue were seen. Lowest Hb% of 1.8 gm/dl, lowest total leucocyte count (TLC) of 500cells/cmm and lowest total platelet count (TPC) of 4000 cells/cmm was noted in a case of aplastic anemia. Macrocytic anemia was predominant blood picture. Hypercellular marrow was noted in 70(70%) cases and common cause was megaloblastic anemia, followed by leukaemia. Hypocellular marrow was noted in 12(12%) patients with aplastic anemia being commonest cause. In our study diagnosis of pancytopenia and its causes were ascertained by hematological investigations. An early and prompt treatment was given according to the cause and severity. Most of the cases had good prognosis due to a treatable cause.

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