CLINICAL AND ETIOLOGICAL PROFILE OF PATIENTS PRESENTING WITH PANCYTOPENIA IN A TERTIARY CARE CENTRE OF ARUNACHAL PRADESH.

Abstract

Pancytopenia is a clinical phenomenon characterized by reduction in 3 cell lineage-erythrocytes, leukocytes and platelets¹.Whenever a clinician encounters a case of pancytopenia, major challenge is to reach a diagnosis and rule out causes of pancytopenia². Here we present case series of 7 patient who presented with pancytopenia and was diagnosed with varied etiology.

Background : Causes of pancytopenia can be divided into Marrow causes and non-marrow causes³.

Marrow causes includes Aplastic anemia, acute leukemias, bone marrow fibrosis, myelodysplastic syndrome and infiltrative diseases mainly due to malignant cells are major causes of bone marrow failure.

Non marrow causes include Hypersplenic state, systemic lupus erythematosus, infections (Tuberculosis, HIV, leishmaniasis and brucellosis) and nutritional deficiency (folate, B12). Chemotherapeutic agents, antibiotics (chloramphenicol, sulphonamides), antiepileptic drugs (Carbamazepine, Phenytoin, Valproic acid), and heavy metals such as gold are known therapeutic agents associated with increased risk of aplastic anaemia.⁴Virus such as parvovirus B19, hepatitis viruses (non-A, non-B, non-C, non-G hepatitis) and HIV are known viral causes of aplastic anaemia.

Patients with history of ethanol ingestion and proven chronic liver disease were excluded from the study. In this study all patients with history of Chronic ethanol ingestion and documented chronic liver disease were excluded, since patient with Chronic liver disease have hypersplenism and may manifest as pancytopenia. Also ethanol ingestion can cause bone marrow suppression⁷.