Dr. Priyadarshini Biswal
BACKGROUND Several diseases can cause bone marrow failure, resulting in greatly reduced to absent haematopoiesis with subsequent pancytopenia. Pancytopenia which includes deficiency of all three cellular elements of blood resulting in anaemia, leucopoenia and thrombocytopenia is a common haematological entity that we have come across in routine practice. Hence a detailed clinical examination, thorough haematological investigation and bone marrow study of patients usually helps in identification of the underlying cause and adds to the pathologist’s role as a consultant to the patient’s treating physician. MATERIALS AND METHODS The study included 100 consecutive cases (both adult and children) with peripheral pancytopenia in the department of haematology (pathology) at SCB MC, Cuttack from January 2017 to April 2018. Patients receiving chemotherapy/radiation were excluded. Apart from detailed clinical examination, complete blood count, peripheral smear examination and bone marrow study (aspiration/trephine biopsy) were conducted. This was a cross sectional study. RESULTS The 100 consecutive cases showed a male predominance (58%). Most common clinical presentation was generalised weakness followed by fever. Most common cause for pancytopenia in adults was aplastic anaemia (40%) and acute leukaemia in children (60%). This was closely followed by Megaloblastic Anaemia (36%) whereas aplastic anaemia (40%) was second most common cause for pancytopenia among paediatric age group. Other causes included MDS with excess blast and hypersplenism. CONCLUSION Out of 100 consecutive cases, aplastic anaemia was most common cause of pancytopenia closely followed by megaloblastic anaemia in adults; whereas in paediatric cases, acute leukaemia was the most common cause followed by aplastic anaemia. The role of bone marrow study along with detailed clinical and haematological evaluation plays a very important role
