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A Clinical-Hematological Study of Pancytopenia Patients Attending Nanakaly Hospital in Erbil City

Authors: Alan Isaac Isho --- Nawsherwan Sadiq Mohammad
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2016 Volume: 5 Issue: 1 Pages: 129-142
Publisher: Al-Mustansyriah University الجامعة المستنصرية


Background: Pancytopenia is a triad of low hemoglobin, white blood cells and platelets.Although it is a common clinical problem with an extensive differential diagnosis, there is arelatively little discussion of this abnormality in major textbooks of internal medicine andhematology.Objectives: This study aimed to determines the etiology and clinical profile of pancytopenicpatients attending Nanakaly hospital.Materials and Methods: During a period of 6 months, 60 pancytopenic patients attendedNanakaly hospital, their ages ranged between one-81years. A control group of 50 age-matchedapparently healthy person were tested for complete blood picture and reticulocyte count. History,physical examination and hematological parameters at presentation were recorded. Hematologicalprofile included hemoglobin, total and differential leukocyte count, platelet count, reticulocytecount, peripheral blood and marrow smears together with marrow biopsy were assessed.Pancytopenic cancer patients on chemotherapy were excluded. Pancytopenia was defined ashemoglobin less than 10g/dl, WBC less than 4 x109/L and platelet count less than 150 x 109/L.Results: The mean Hb concentration, WBC count and platelet count in studied group weresignificantly lower than in control group. Hematological malignancies were the commonest causeof pancytopenia and accounted for (51.7%), they included: Acute leukemia (35%),myelodysplastic syndrome (11.7%), hairy cell leukemia (3.3%) and myelofibrosis (1.7%). Aplastic and megaloblastic anemia each of them accounted for (16.7%), hypersplenism wasresponsible for (10%). Other less common causes included enteric fever, kalaazar and secondarymetastasis each of them accounted for (1.7%). Pallor was present in every case. Fever was presentin (63.3%) and (25%) had bleeding manifestations at the time of presentation Conclusions: The most common causes of pancytopenia were acute Leukemia, aplastic anemiaand Megaloblastic anaemia, but rare causes like myelofibrosis, enteric fever, kala azar andsecondary metastasis should also be kept in mind.

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