A study of Bone marrow aspiration smears and Trephine biopsy in Pancytopenia cases.
Keywords:
Pancytopenia, Megaloblastic anemia, Aplastic anemia, Bone marrow examination
Abstract
Background: Pancytopenia is the simultaneous presence of anemia, leucopenia and thrombocytopenia. Peripheral pancytopenia may be a manifestation of a wide variety of disorders which primarily or secondarily affects the bone marrow. Bone marrow failure syndromes and malignancies are serious and life threatening causes, but certain non-malignant conditions such as infection, and nutritional anemia are equally important. The severity of pancytopenia and the underlying pathology determine the implementation of correct management and prognosis. Methods: A prospective study was conducted in the Upgraded Department of Pathology, Osmania government general hospital during July 2011 to September 2013that evaluated 110 patients fulfilling the criteria of pancytopenia. Detailed history, thorough clinical examination, complete hemogram, peripheral examination and reticulocyte count evaluation was performed in all the 110 patients. Bone marrow aspiration was performed in all 110 patients and in addition trephine biopsy was done in the same setting in patients where it is indicated.Result: The patients aged from 15 to 75 years,average age at presentation was 30.9yrs. The most common cause of pancytopenia was Megaloblastic anemia (53%) followed by Nutritional anemia (16%), aplastic anemia (9%) and Leukemia’s (7.4%). Majority (79%) of the patients had hyper cellular bone marrow followed by hypocellular (13%) and norm cellular marrow (8%).Conclusion: A detailed primary hematological investigations coupled with bone marrow examination viewed in light of the history and physical findings are vital in establishing the diagnosis in pancytopenia patients. Bone marrow Aspiration and Trephine biopsy are complementary to each other in cases requiring both the procedures.References
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2) Ur-Rehman H, Fazil M, Mohammad F. Clinical presentation of pancytopenia in children under 15 years of age. J Postgrad Med Inst 2003; 17(1): 46-51.
3) Firkin F, Chesterman C, Penington D, Rush B. De Gruchy’s Clinical haematology in Medical Practice. 5th Ed. Oxford: Blackwell; 1989.
4) ) International agranulocytosis and aplastic anaemia study. Incidence of
aplastic anaemia, the relevance of diagnostic criteria. Blood 1987; 70 (6):
1718-21.
5) Wintrobe MM. Clinical Haematology. 8th Ed. Philadelphia: Lea and
Febiger; 1981.
6) Keisu M, Ost A. Diagnosis in patients with severe pancytopenia suspected
of having aplastic anaemia. Eur J Haematol 1990; 45: 11-4.
7) Varma N, Dash S. A reappraisal of underlying pathology in adult patients
presenting with pancytopenia. Trop Geogr Med 1992; 44(4): 322-7.
8) Dodhy MA, Bokhari N, Hayat A. Aetiology of Pancytopenia, A five-year
experience. Ann Pak Inst Med Sci 2005 Apr-Jun;1 (2):92-5.
9) Osama I, Baqai Hz, Anwar F, Hussain N. Patterns of pancytopenia in a general medical ward and a proposed diagnostic approach. JAMC 2002; 16(1):8-13.
10) Gagandeep Kaur, Sabita Basu, Paramjit Kaur and Tanvi Sood: “metastatic bone marrow tumors: study of nine cases and review of the literature”; J Blood Disorder and Transfusion 2011; Vol 2 , Issue 3:2-3.
Published
2016-08-21
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