Limits...
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 increased plasma cells with binucleate forms (Leishman, ×1000)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3118050&req=5

Figure 6: Bone marrow showing increased plasma cells with binucleate forms (Leishman, ×1000)

Mentions: We encountered 4 patients of subleukemic leukemia; their age ranged from 4 to 30 years. Three cases were of AML-M2 (acute myeloblastic leukemia) and 1 case was of ALL-L2 (acute lymphoblastic leukemia). Bone marrow was hypercellular in all cases. Erythroid and megakaryocytic series were reduced. Majority of cells were myeloblasts and lymphoblasts, constituting more than 40% and 30% of cells in marrow, respectively. Bone marrow aspirate showed myeloblasts with Auer rods [Figure 4]. Malarial infestation was seen in 2 male patients aged 5 years and 25 years. Peripheral blood picture showed pancytopenia, and gametocytes of plasmodium falciparum were seen in blood smear in both cases [Figure 5]. BM was hypercellular with megaloblastic change. No malarial parasites were seen on bone marrow smears. The patients recovered after antimalarial treatment and folic acid therapy. Multiple myeloma was diagnosed in a 41-year-old female, who presented with weakness and bony tenderness. BM showed abnormal proliferation of plasma cells, constituting >40% of marrow cells, including good number of binucleate and trinucleate forms [Figure 6].


Pancytopenia: a clinico hematological study.

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

Bone marrow showing increased plasma cells with binucleate forms (Leishman, ×1000)
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 6: Bone marrow showing increased plasma cells with binucleate forms (Leishman, ×1000)
Mentions: We encountered 4 patients of subleukemic leukemia; their age ranged from 4 to 30 years. Three cases were of AML-M2 (acute myeloblastic leukemia) and 1 case was of ALL-L2 (acute lymphoblastic leukemia). Bone marrow was hypercellular in all cases. Erythroid and megakaryocytic series were reduced. Majority of cells were myeloblasts and lymphoblasts, constituting more than 40% and 30% of cells in marrow, respectively. Bone marrow aspirate showed myeloblasts with Auer rods [Figure 4]. Malarial infestation was seen in 2 male patients aged 5 years and 25 years. Peripheral blood picture showed pancytopenia, and gametocytes of plasmodium falciparum were seen in blood smear in both cases [Figure 5]. BM was hypercellular with megaloblastic change. No malarial parasites were seen on bone marrow smears. The patients recovered after antimalarial treatment and folic acid therapy. Multiple myeloma was diagnosed in a 41-year-old female, who presented with weakness and bony tenderness. BM showed abnormal proliferation of plasma cells, constituting >40% of marrow cells, including good number of binucleate and trinucleate forms [Figure 6].

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