Clinical and Hematological Profile of Patients With Pancytopenia at Jimma Medical Center, Southwest Ethiopia

Abstract

Background: Pancytopenia is the simultaneous presence of anemia, leucopenia and thrombocytopenia. The underlying mechanisms are decrease in hematopoietic cell production, marrow replacement by abnormal cells, suppression of marrow growth and differentiation, ineffective hematopoiesis with cell death and defective cell formation. Overall, these hematological conditions represent the most frequent cause of clinical occurrence and death worldwide. There is no adequate data regarding pancytopenia because of rareness. Objectives: To determine the clinical and hematological profile of patients with pancytopenia visiting Jimma Medical Center from May 13 to September 13, 2022. Method: A facility based cross-sectional study was conducted by recruiting consecutively identified 163 patients with pancytopenia within a five months period. Three ml of venous blood collected in K2EDTA 4ML tube and CBC parameters were analyzed by Beckman coulter. The peripheral blood morphology study was performed on blood films stained with Wright’s stain. Socio-demographic data, clinical diagnosis and causes were obtained from medical records using a check lists. The data was entered Epi data v4.6 and imported to SPSS, and descriptive statistics, associations were done. The final results were presented by tables and figures. P value of <0.05 was set as a cutoff point of significance. Results: A total of 163 patients were included. The highest distribution of pancytopenia was seen 50.9% in males and 57.1% in urban residents. The most common morphological features were seen 43% microcytic red cells, 36% left shifts and toxic granulation white cells, and 20.9% large platelets. Almost half of patients 49.7% were in critical conditions. The most common causes were hyper-reactive malarial splenomegaly (28%), megaloblastic anemia (21%), and undifferentiated causes of pancytopenia 12% respectively. Conclusions: The finding showed the mean values of hematological profiles of patients with pancytopenia were significantly lower than normal range mean. The morphological features of the blood cells are varied in size, shape, cytoplasmic inclusions and hemoglobin concentration. But further studies with larger sample size from other settings are required to substantiate the findings in the future.