Clinico-hematological profile in patients of pancytopenia and role of nutritional deficiencies as important aetiological and preventable factor in causing pancytopenia in India

Observational and descriptive cross-sectional study-150 patients, >18 yrs age,evaluated clinically with haematological parameters and bone marrow aspiration.RESULTS-Majority patients presented with fatigue, breathlessness(87.3%) and fever(52.7%). Commonest sign was pallor, followed by splenomegaly, hepatomegaly.Commonest BM picture was hypercellular.Most common aetiology was megaloblastic anaemia(34%),followed by infections(21.3%),hypersplenism(11.3%) and iron deficiency anaemia (8%).Nutritional deficiencies constituted 42% of cases.36% patients had normocellular bone marrow,54.6% patients had hypercellular bone marrow and 9.3% patients had hypocellular bone marrow.Hypocellular BM patients-severe anaemia(42.8%),moderate leucopenia (64.28%)& severe thrombocytopenia.Hypercellular BM patients-moderate anaemia(53.65%),moderate leucopenia(53.65%).CONCLUSION-clinical history & physical examination along with baseline haematological investigations and BMA(biopsy if needed) provide invaluable information, helping in systematic planning of further investigations to diagnose and acertain the cause,avoiding unnecessary tests which not only add to expense of treatment but sometimes may also delay diagnosis and treatment in pancytopenia patients. Pancytopenia is a triad of findings resulting from disease processes primarily or secondarily involving bone marrow ranging from megaloblastic anaemia, aplastic anaemia, disseminated kochs, enteric fever, leishmaniasis to lethal haematological malignancies so all these causes should be kept in mind while planning investigations for the workup of pancytopenic patients.Megaloblastic anaemia and iron deficiency anaemia were the most common causes of pancytopenia in our study which is easily treatable and reversible cause of pancytopenia and thus has a good prognosis.Its early diagnosis is important to prevent further complications.