Causes of pancytopenia based on bone marrow examination in adult patients presenting at Muhimbili National Hospital

Authors

  • Pius Mwita Magesa Muhimbili University of Health and Allied Sciences
  • Alex Sifaeli Magesa Muhimbili National Hospital
  • Stella Samson Rwezaula Muhimbili National Hospital
  • Elineema Collin Meda Muhimbili National Hospital

DOI:

https://doi.org/10.4314/tmj.v30i1.275

Abstract

Background

Pancytopenia is the simultaneous presence of anaemia, leucopenia and thrombocytopenia. The aetiological spectrum of pancytopenia is wide and variable. We aimed to determine the common causes of pancytopenia by analyzing bone marrow aspiration records of adult patients seen at Muhimbili National Hospital, a tertiary care centre.

Methods

This was a retrospective descriptive cross-sectional study of all adult patients who presented with pancytopenia for a period of one year from January 2013 to December 2013. All patients with pancytopenia, i.e. Hb < 10 g/dl, WBC < 4 x 109/l and platelet count < 150 x 109/l; aged ? 18 years; and of both sexes were included in the study. The data obtained were entered on excel sheets, cleaned and analyzed for averages and ranges for numerical data. Categorical data were summarized by averages of frequencies and proportion.

Results

A total number of 216 adult patients had bone marrow examination in one year. A full blood picture was retrieved in 153 patients and among these, 26.8% (n = 41) had pancytopenia. The common causes of pancytopenia were aplastic anaemia (48.8%); haematological malignancies (29.3%); and nutritional anaemia (17.0%). Acute myeloid leukaemia was the commonest malignancy comprising 50% of all haematological neoplasms and iron deficiency occurred in 71.4% of nutritionally anaemic patients.

Conclusion

Aplastic anaemia was the most common aetiological factor followed by haematological malignancies among adult patients presenting with pancytopenia at Muhimbili National Hospital. The high frequency of iron deficiency anaemia with pancytopenia was unusual.

Key words:  pancytopenia, aetiology, bone marrow, adult patients

Author Biographies

  • Pius Mwita Magesa, Muhimbili University of Health and Allied Sciences

    Department of Haematology and Blood Transfusion; Senior Lecturer

  • Alex Sifaeli Magesa, Muhimbili National Hospital
    Department of Laboratory Services; Haematologist
  • Stella Samson Rwezaula, Muhimbili National Hospital
    Department of Laboratory Services; Haematologist
  • Elineema Collin Meda, Muhimbili National Hospital
    Department of Laboratory Services; Haematologist

References

Lewis SM (2006). Reference ranges and normal values. In Lewis SM, Bain BJ and Bates I (Eds.), Dacie and Lewis Practical Haematology (pp. 11-24). Philadephia PA: Churchill Livingstone.

Saathoff, E, Schneider P, Kleinfeldt V, Geis S, Haule D, Maboko L, Samky E, de Souza M, Robb M and Hoelscher M (2008). Laboratory reference values for healthy adults from southern Tanzania. Tropical Medicine and International Health, 13(5): 612-625. DOI: 10.1111/j.1365-3156.2008.02047.x

Imbert M, Scoazec JY, Mary JY, Jouzult H, Rochant H, Sultan C. Adult patients presenting with pancytopenia: a reappraisal of underlying pathology and diagnostic procedures in 213 cases. Hematol Pathol. 1989; 3:159-167.

Tilak V & Jain R (1999). Pancytopenia - A clinico-haematologic analysis of 77 cases. Indian J Pathol Microbiol; 42:399-404.

Jha A, Sayami G, Adhikari RC, Panta AD, Jha R. Bone marrow examination in cases of pancytopenia. J Nepal Med Assoc. 2008; 47:12-17.

Varma N, Dash S. A reappraisal of underlying pathology in adult patients presenting with pancytopenia. Trop Geogr Med. 1992; 44:322-327.

Makheja KD, Maheshwari BK, Arain S, Kumar S, Kumari S, Vikash. The common causes leading to pancytopenia in patients presenting to tertiary care hospital. Pak J Med Sci 2013 Sept-Oct; 29(5): 1108 – 1111.

Gayathri BN and Rao KS. Pancytopenia: A clinico-hematological study. J Lab Physicians 2011 Jan-Jun; 3(1): 15 – 20. DOI: 10.4103/0974-2727.78555.

Isho AI, Mohamed NS, Nooruldin SA. A clinical – haematological study of pancytopenia in patients attending Nanakaly Hospital in Erbil City. Iraqi J Haematology; May 2016; 5(1): 129-142.

Memon S, Shaikh S, Nizamani MA. Aetiological spectrum of pancytopenia based on bone marrow examination in children. J Coll Physicians Surg Pak. 2008 Mar; 18(3): 163 – 7. doi: 03.2008/JCPSP.163167.

Gupta V, Tripathi S, Tilak V, Bhatia BD. A study of clinico-haematological profiles of pancytopenia in children. Trop Doct. 2008 Oct; 38 (4): 241 – 3. DOI: 10.1258.td.2008.070422.

Shano Naseem, Neelam Varma, Reena Das, Jasmina Ahluwalia, Man Updesha Singh Sachdeva, Ram Kumar Marwaha. Pediatric patients with bicytopenia/pancytopenia: Review of etiologies and clinico-hematological profile at a tertiary center. Indian J Patholo Microbiol 2011; 54(1): 75 – 80.

Kinoshita T, Inone N. Relationship between aplastic anemia and paroxysmal nocturnal hemoglobinuria. Int J Hematol. 2002 Feb; 75(2): 117 – 22.

Jhamb R, Kumar A. Iron deficiency anemia presenting as pancytopenia in an adolescent girl. Int J Adolesc Med Health. 2011; 23(1): 73 – 4

Ganti AK, Shonka NA, Haire WD. Pancytopenia due to iron deficiency worsened by iron infusion: a case report. J Med Case Rep. 2007 Dec 7; 1: 175. DOI: 10.1186/1752-1947-1-175.

The International Agranulocytosis and Aplastic Anaemia Study. Incidence of aplastic anaemia: The relevant diagnostic criteria. Blood 70: 1718, 1987.

Mary JY, Baumelou E, Guiguet M: Epidemiology of aplastic anaemiain France: A prospective multicentre study. Blood 75: 1646, 1990.

Chongli Y and Ziaobo Z: Incidence survey of aplastic anaemia in China. Chin Med Sci J 6: 203, 1991.

Downloads

Published

2019-09-24

Issue

Section

Case Reports

How to Cite

Causes of pancytopenia based on bone marrow examination in adult patients presenting at Muhimbili National Hospital. (2019). Tanzania Medical Journal, 30(1), 98-107. https://doi.org/10.4314/tmj.v30i1.275

Most read articles by the same author(s)

<< < 4 5 6 7 8 9 10 11 12 13 > >>