Pancytopenia; study of 40 patients at cmc hospital larkana

ABSTRACT

Pancytopenia is said to exist in an adult when the hemoglobin level is less than 13.5gm/dl in males and 1l.5gm/dl in females, white cell count less than 4x10[9]L[1] and platelet count less than 150x10[9]/L[1]. The causes of pancytopenia are aplastic anemia, subleukemic leukemia, myelodysplasia [2] multiple myeloma, nutritional deficiencies leading to megaloblastic anemia, hypersplenism, paroxysmal nocturnal hemoglobinuria, AIDS, infections such as miliary tuberculosis, leishmaniasis, brucellosis etc. To determine the frequency of various causes of pancytopenia in gender at Chandka Medical College, Larkana. Cross Sectional Study. OPD and Medical Ward-ll, Chandka Medical College Hospital Larkana. 01 years study from February 2007 to February 2008. Patients of either sex, who attended medical ward-ll of Chandka Medical College Hospital Larkana, either as inpatient or out patient department, from February 2007 to February 2008 and fulfilled the inclusion criteria, were included in this study. Pancytopenia was considered as hemoglobin value less than 13.5gm/dl in males or 11.5gm/dl in females, a white cell count less than 4x10[9]/L and Platelets count less than 150x10[9]/L. Patients of less than 12 years and pregnant females were excluded from the study. Out of 40 patients, 29 [72.5%] were males and 11 [27.5%] were females. Female to male ratio was 12.6. The mean ages of males were 29.10 +/- 16.46 years whereas of females 36.14 +/- 15.6 years [P = 0.22]. Aplastic anemia was the most common pathology encountered and was diagnosed in 13 cases [31.5%], followed by hypersplenism 09 [22.9%], Megaloblastic anemia 06 [15%] and hodgkin's lymphoma in 04 [10%] cases. Other less common causes detected were multiple myeloma 02 [5%], drug induced 02 [5%] and malaria, milliary tuberculosis, myelodysplastic syndrome, emophagocytic syndrome was 01 [2.5%] case in each. We concluded that aplastic anemia was the most common cause in our patients and more than 2/3rd patients were young males. We think the causes of aplastic anemia in this study may be misuse of drugs, kushtas, exposure to chemicals and viral infections