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The etiological spectrum of pancytopenia diagnosed from blood smears examined in the pathology department of a rural tertiary care centre in South India

Suryareshmi B S, Latha K. Abraham, Anna Mathew, John Michael Raj.


Background: Pancytopenia is a reduction in all three formed elements of blood, namely - erythrocytes, leukocytes, and platelets. This triad of findings occurs in a number of clinical conditions. The underlying pathology determines the management and prognosis of the patients. Identification of the precise cause is exceptionally challenging and requires a systematic study on the detailed clinical history, drug history, and comorbidities of the patients. Early diagnosis and initiation of prompt therapy will be lifesaving. The causes of pancytopenia vary in different populations and this study will document the etiology of pancytopenia in this region.

Objectives: The objectives of this study were to find out the prevalence and etiological spectrum of pancytopenia in patients diagnosed to have pancytopenia from blood smears done in this institution.

Materials and Methods: This is a cross-sectional, medical record-based study of patients diagnosed to have pancytopenia from peripheral blood smears to find the prevalence of pancytopenia in patients coming to this rural teaching hospital during a 7 months period in 2015.

Results: Of the 2813 blood smears examined in the pathology department of this rural medical college, 61 (2.16%) were diagnosed to have pancytopenia. Of these, 46 patients who fulfilled the selection criteria were recruited to the study. The most common causes of pancytopenia were chronic liver disease (17, 37%), followed by dengue fever (9, 19.6%) and hematological malignancies (4, 8.7%). The common presenting symptoms were fatigue and weakness (36, 76.1%) and fever (26, 56.6%). The most common presenting signs were pallor (9, 19.6), splenomegaly (7, 15.2%), and hepatomegaly (6, 13%).

Conclusion: Chronic liver disease related to alcoholism and dengue fever is the most common causes of pancytopenia in this clinical setting. The common presenting symptoms include fever and fatigue.

Key words: Pancytopenia; Blood Smear; Hepatomegaly; Splenomegaly

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