ETIOLOGICAL SPECTRUM OF CYTOPENIAS IN ADULT PAKISTANI POPULATION: A SINGLE CENTRE EXPERIENCE

Abstract

ABSTRACT OBJECTIVE: To determine the frequency and etiology of various cytopenias in adult patients presenting to the medical unit of Kuwait Teaching Hospital, Peshawar, Pakistan. METHODS: The study was conducted from January 2015 till June 2016, on 115 patients presenting to medical unit of Kuwait Teaching Hospital, Peshawar, Pakistan. Out of these 62 (54%) were males and 53 (46%) were females. Patients above 15 years of age having various cytopenias on complete blood count were included in the study. This was followed by peripheral smear examination. Bone marrow aspiration and trephine biopsy was performed where indicated. The data was further stratified into pancytopenia, thrombocytopenia and anemia and their respective causes with frequencies were calculated. RESULTS: Pancytopenia was detected in 66/115 (57.4%) cases. Megaloblastic anemia (n=29/66; 43.9%), aplastic anemia (n=10/66; 15.2%) and acute leukemia (n=10/66; 15.2%) were the major causes of pancytopenia. Other causes of pancytopenia included multiple myeloma (n=9/66; 13.6%), disseminated intravascular coagulation (n=4/66; 6.1%), myelo-suppression (n=2/66; 3%) and myelodysplasia (n=2/66; 3%). Thrombocytopenia was diagnosed in 44/115 (38.3%) cases. Vivax malaria (n=19/44; 43.2%), idiopathic thrombocytopenic purpura (n=11/44; 25%), hypersplenism (n=7/44; 15.9%) and dengue hemorrhagic fever (n=4/44; 9.1%) were the main causes of thrombocytopenia. Iron deficiency anemia was observed in 5/115 (4.3%) cases, all were females. CONCLUSION: Pancytopenia and thrombocytopenia are the commonest cytopenias encountered in adult patients presenting to a medical unit in our hospital. Megaloblastic anemia is the commonest cause of pancytopenia followed by aplastic anemia and leukemia. In thrombocytopenia, vivax malaria and idiopathic thrombocytopenic purpura were the commonest causes. KEY WORDS: Cytopenias (Non-MeSH); Thrombocytopenia (MeSH); Pancytopenia (MeSH); Anemia (MeSH); Peripheral smear (Non-MeSH); Bone marrow (MeSH); Trephine biopsy (Non-MeSH); Biopsy (MeSH); Anemia, Iron-Deficiency (MeSH).