Clinico etiological profile of pancytopenia with special reference to vitamin b12 and folic acid level

Abstract

Introduction: Pancytopenia is characterized by reduced in all three hematopoietic cell lines erythrocytes, lymphocytes and platelets that leads to anemia, leucopenia, and thrombocytopenia. It is not a disease entity by itself but the condition shared a common pathway caused by a wide range of distinct etiologies, including nutritional, autoimmune, infections, neoplastic, and/or hereditary. When a main production defect causes pancytopenia, the bone marrow typically exhibits hypocellularity. Increased utilization of peripheral cell or destruction are associated with a hypercellular or normocellular marrow. To determine the cause of pancytopenia is a challenge and is important in determining the proper treatment regimen and estimating prognosis.

Aims: To study the etiology and clinical profile of pancytopenia with special reference to Vit B12 and Folic acid level.

Material and Methods: This was a hospital based cross sectional study; it was carried out on 50 patients of pancytopenia admitted in department of General Medicine at Jorhat medical college and hospital in the period from March 2023 to February 2024. A total of 50 patients were subjected to Bone marrow examination and Vit B12 and Folic acid level estimation were also done.

Results: The presents study showed that most common age group affected were between 18 to 30 years. Male were affected more than female. In the present study, majority of cases were diagnosed as megaloblastic anaemia (48%), followed by aplastic anaemia (16%), decompensated chronic liver disease (8%). Multiple myeloma was the least common etiological factor accounting for two cases only.

Conclusion: Detailed examination of peripheral blood smear along with reticulocyte count reveals important information regarding etiology, e.g macro-ovalocytes with hypersegmented neutrophils in megaloblastic anaemia, absence of any abnormal/immature cell in aplastic anaemia. However, the diagnostic accuracy is increased manifolds when detailed clinical history and examination are combined with complete blood counts and peripheral smear. Although, bone marrow study provides the definitive diagnosis in cases of pancytopenia.