Nazish Shinwari, Fazle Raziq, Khalid Khan, Farooq Taj Uppal, Hamzullah Khan.
Pancytopenia: experience in a teriary care hospital of Peshawar, Pakistan.
Rawal Med J Jan ;37(4):370-3.

Objectives: To determine the causes of pancytopenia, in patients presenting to a tertiary care hospital of Peshawar. Subject and methods: This cross sectional study was conducted in the department of pathology, Hayatabad Medical Complex, Peshawar, from Sept 2007 to February 2009. A total of hundred patients with established diagnosis of the pancytopenia were selected through non-probability sampling techniques. Relevant information’s were obtained from the patients with the help of a predesigned questionnaire prepared in accordance with the objectives of the study. Results: Out of 455 patients who underwent bone marrow biopsies, 100 patients were selected who were fulfilling the inclusion criteria. Sixty four patients were males and 36 females. The age range f the patients was from <1 year up to 70 years with mean age 18 ± 15.8years. Seventy two percent of patients presented with most common features of anemia. About (45%) patients presented with symptoms related to neutropenia and 35% presented with bleeding disorders and (19%) with patiechiel spots. Regarding risk assessment 3 (3%) patients had used antipyretics, antimalarials and antibiotics for long times for various disorders. Out of total 78% patients had a poor financial status. Blood transfusion history was found in 80% patients. Mean hemoglobin with SD was 6.8+ 1.8. mean leukocytes count was mean was 2818.77/cmm with SD + 3746.97. Mean platelet count was 44040.0 with SD + 43318.86.Mean reticulocyte count of 1.76 with SD + 1.98. Megaloblastic anemia contributed n=27 (27%) cases Out of total (18%) were ALL and 5 (05%) cases were AML. Aplastic anemia was recorded in (21%) cases. Fourth cause in descending order was hypersplenism 11% and visceral leishmaniasis was noted in 8%. Conclusion: Pancytopenia is an important clinical problem, occurring more common in males. Megaloblastic anemia and malignant causes are major contributor to pancytpenia in our set up. Bone-marrow examination is an established diagnostic modality. The common causes of pancytopenia in our community, are completely curable while others can be treated to reduce morbidity and prolong survival.

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