Abstract

A CLINICAL STUDY OF CYTOPENIAS WITH SPECIAL REFERENCE TO MEGALOBLASTIC ANAEMIA IN A TERTIARY CARE CENTRE

Author(s): Ubedul Islam1, Rahul Valsaraj2, Nilakshi Goswami3

BACKGROUND
Peripheral cytopenia is defined as reduction in either of the cellular elements of blood, i.e. red cells, white cells, or platelets. The aetiology varies widely ranging from transient marrow suppression by viral infections to marrow infiltration by life-threatening malignancy. Megaloblastic anaemia is not uncommon in India. Diagnosing this disease assumes great clinical importance since it responds exceedingly well to treatment.
OBJECTIVES
To study the aetiology and clinical profile of patients with cytopenias with special reference being made for cytopenias in megaloblastic anaemia.
MATERIALS AND METHODS
An observational study was conducted on 149 patients who presented with cytopenias to the Dept. of General Medicine and Dept. of Haematology, GMCH, Guwahati, during the period of June 2014 to May 2015. Their clinical profile, complete haemogram, and bone marrow examination were studied.
RESULTS
A total of 149 patients with cytopenia were studied. The patients were predominantly males with mean age of 37 years. Bicytopenia (59.7%) was more commonly seen than pancytopenia (40.3%). The most common cause of cytopenia was Megaloblastic Anaemia (28.2%) followed by Acute Myeloid Leukaemia (22.1%). Majority of the patients presented with Generalised Weakness (94.6%) and Fatigue (74.5%). Most common physical finding was Pallor (94.6%) followed by Splenomegaly (40.3%) and Hepatomegaly (36.2%). Of the 42 patients with Megaloblastic Anaemia, majority of the patients had a macrocytic (71.5%) peripheral blood smear followed by dimorphic picture (21.3%) of which all but 7 patients had hypersegmented neutrophils. Bone marrow examination was done in 31 patients of megaloblastic anaemia, which showed mainly a hypercellular marrow (83.8%).
CONCLUSION
A detailed clinical history and meticulous physical examination along with a complete haemogram and bone marrow examination in patients presenting with cytopenias is useful in diagnosing the aetiology and initiating quick management.