A study of clinico-hematological profile of pancytopenic patients in Central India

Background: To segregate the causes of pancytopenia which are easily treatable, from those requiring sophisticated investigations & vigorous treatment, based on clinico-hematological profile of the patients and affordable diagnostic mathods. Materials and Methods: 180 Pancytopenic patients were evaluated clinically along with hematological parameters, peripheral smears and bone marrow aspiration in the Department of Pathology, GMC, Bhopal for 3 years. Result: Age range was 5 months-70 years (mean- 26.6 years), with Male preponderance (M: F: 1.76:1). Commonest symptoms were weakness (97.8%), breathlessness (75%) and signs were pallor (98.3%) and splenomegaly (25.5%). Patients who presented with per rectal bleeding, in 46.2% diagnosis was dimorphic anemia thus per rectal bleeding was cause of associated iron deficiency. Commonest peripheral smear finding was microcytic hypochromic picture (27.22 %) & bone marrow was hypercellular (70.00%). Bone marrow aspiration revealed commonest cause was megaloblastic anemia (25%) followed by dimorphic anemia (17.2%) and infections (17.2%). In our study MCV was <100 fl in 12/45 (26.66%) cases of megaloblastic anemia so even if a patient presents with MCV < 100 fl megaloblastic anemia should not be ruled out only on this basis. Sensitivity of peripheral smear for dimorphic anemia was very low 35.48% and specificity was 82.55%, so bone marrow examination should be investigation of choice for inconclusive peripheral smears. Conclusion: Common causes of pancytopenia were easily treatable and reversible & can be detected by early and affordable diagnostic methods therefore should be considered at higher order in differential diagnosis of pancytopenia.