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Pancytopenia: a clinico hematological study.

Gayathri BN, Rao KS - J Lab Physicians (2011)

Bottom Line: The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly.Dimorphic anemia was the predominant blood picture.These are also helpful in planning further investigations and management.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, SDUMC, Tamaka, Kolar, India.

ABSTRACT

Background: Pancytopenia is a relatively common hematological entity. It is a striking feature of many serious and life-threatening illnesses, ranging from simple drug-induced bone marrow hypoplasia, megaloblastic anemia to fatal bone marrow aplasias and leukemias. The severity of pancytopenia and the underlying pathology determine the management and prognosis. Thus, identification of the correct cause will help in implementing appropriate therapy.

Objectives: To study the clinical presentations in pancytopenia due to various causes; and to evaluate hematological parameters, including bone marrow aspiration.

Materials and methods: It was a prospective study, and 104 pancytopenic patients were evaluated clinically, along with hematological parameters and bone marrow aspiration in Hematology Unit, Department of Pathology, JJMMC, Davanagere, during the period of September 2005 to September 2007.

Results: Among 104 cases studied, age of patients ranged from 2 to 80 years with a mean age of 41 years, and male predominance. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. Dimorphic anemia was the predominant blood picture. Bone marrow aspiration was conclusive in all cases. The commonest marrow finding was hypercellularity with megaloblastic erythropoiesis. The commonest cause for pancytopenia was megaloblastic anemia (74.04%), followed by aplastic anemia (18.26%).

Conclusion: Thepresent study concludes that detailed primary hematological investigations along with bone marrow aspiration in cytopenic patients are helpful for understanding disease process and to diagnose or to rule out the causes of cytopenia. These are also helpful in planning further investigations and management.

No MeSH data available.


Related in: MedlinePlus

Bone marrow showing megaloblasts, with royal blue cytoplasm and sieve-like chromatin (Leishman, ×1000)igure 1: Peripheral smear showing macrocytic anemia with hypersegmented neutrophils (Leishman, ×1000)
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Figure 2: Bone marrow showing megaloblasts, with royal blue cytoplasm and sieve-like chromatin (Leishman, ×1000)igure 1: Peripheral smear showing macrocytic anemia with hypersegmented neutrophils (Leishman, ×1000)

Mentions: Megaloblastic anemia was observed in 43 males and 34 females, their age ranging from 4 to 80 years, with a mean age of 42 years. Four patients had evidence of malabsorption syndrome. Six patients had clinical neurological deficits: subacute combined degeneration (SACD) of spinal cord in 4 and sensory ataxia in 2 patients. In the remaining 67 cases, the underlying disorder could not be established. Since B12 and folate levels could not be estimated as a routine, both folic acid and parenteral hydroxycobalamine therapies were administered to all, and they showed complete clinical and hematological remission. Bone marrow aspiration showed megaloblastic erythroid hyperplasia. Megaloblasts had the characteristic feature of sieved nuclear chromatin, asynchronous nuclear maturation and bluish cytoplasm with cytoplasmic blebs [Figure 2]. Giant metamyelocytes and band forms were predominant in granulocyte series.


Pancytopenia: a clinico hematological study.

Gayathri BN, Rao KS - J Lab Physicians (2011)

Bone marrow showing megaloblasts, with royal blue cytoplasm and sieve-like chromatin (Leishman, ×1000)igure 1: Peripheral smear showing macrocytic anemia with hypersegmented neutrophils (Leishman, ×1000)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3118050&req=5

Figure 2: Bone marrow showing megaloblasts, with royal blue cytoplasm and sieve-like chromatin (Leishman, ×1000)igure 1: Peripheral smear showing macrocytic anemia with hypersegmented neutrophils (Leishman, ×1000)
Mentions: Megaloblastic anemia was observed in 43 males and 34 females, their age ranging from 4 to 80 years, with a mean age of 42 years. Four patients had evidence of malabsorption syndrome. Six patients had clinical neurological deficits: subacute combined degeneration (SACD) of spinal cord in 4 and sensory ataxia in 2 patients. In the remaining 67 cases, the underlying disorder could not be established. Since B12 and folate levels could not be estimated as a routine, both folic acid and parenteral hydroxycobalamine therapies were administered to all, and they showed complete clinical and hematological remission. Bone marrow aspiration showed megaloblastic erythroid hyperplasia. Megaloblasts had the characteristic feature of sieved nuclear chromatin, asynchronous nuclear maturation and bluish cytoplasm with cytoplasmic blebs [Figure 2]. Giant metamyelocytes and band forms were predominant in granulocyte series.

Bottom Line: The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly.Dimorphic anemia was the predominant blood picture.These are also helpful in planning further investigations and management.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, SDUMC, Tamaka, Kolar, India.

ABSTRACT

Background: Pancytopenia is a relatively common hematological entity. It is a striking feature of many serious and life-threatening illnesses, ranging from simple drug-induced bone marrow hypoplasia, megaloblastic anemia to fatal bone marrow aplasias and leukemias. The severity of pancytopenia and the underlying pathology determine the management and prognosis. Thus, identification of the correct cause will help in implementing appropriate therapy.

Objectives: To study the clinical presentations in pancytopenia due to various causes; and to evaluate hematological parameters, including bone marrow aspiration.

Materials and methods: It was a prospective study, and 104 pancytopenic patients were evaluated clinically, along with hematological parameters and bone marrow aspiration in Hematology Unit, Department of Pathology, JJMMC, Davanagere, during the period of September 2005 to September 2007.

Results: Among 104 cases studied, age of patients ranged from 2 to 80 years with a mean age of 41 years, and male predominance. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. Dimorphic anemia was the predominant blood picture. Bone marrow aspiration was conclusive in all cases. The commonest marrow finding was hypercellularity with megaloblastic erythropoiesis. The commonest cause for pancytopenia was megaloblastic anemia (74.04%), followed by aplastic anemia (18.26%).

Conclusion: Thepresent study concludes that detailed primary hematological investigations along with bone marrow aspiration in cytopenic patients are helpful for understanding disease process and to diagnose or to rule out the causes of cytopenia. These are also helpful in planning further investigations and management.

No MeSH data available.


Related in: MedlinePlus