• Muhammad Bilal Khattak
  • Mohammad Ismail
  • Zahid Irfan Marwat
  • Faramoz Khan


Background: A wide variety of clinical conditions, that primarily or secondarily affect the bonemarrow may present with pancytopenia, one of such conditions is megaloblastic anaemia. The purposeof this study was to determine the frequency and nature of pancytopenia in megaloblastic anaemia.Methods: This was a prospective, cross-sectional descriptive study conducted in Medical Units, AyubTeaching Hospital, Abbottabad, Pakistan during July 2010–January 2011. Total 90 patients wereincluded in this study. Data were collected including history, clinical examination, haemoglobin level,mean cell volume, bone marrow examination and peripheral smear examination. Results: Of total 90patients, 54 were male and 36 were female. Mean age was 28±15.84 years. Common presentingfeatures were weakness, fever and bleeding manifestations. Pancytopenia was present in 63 (70%)patients. Most common presenting feature related to anaemia was weakness (80%). Bleedingmanifestations, related to low platelet count were found in 35 (39%) patients. Physical Examinationfindings were: pallor (100%), splenomegaly (33%), bleeding manifestations (25%), hepatomegaly(17%), and hepatosplenomegaly (19%). Mean peripheral blood findings of the study populationincluded haemoglobin level (6.25 g/dL), total leukocyte count (2818.7/μL), platelet count (44040/uL),and reticulocyte count (1.7%). Mean values for red cells indices included red blood cells count (2.6million/uL), mean corpuscular volume (114.3 fL), mean corpuscular haemoglobin (27.3 ρg) and meancorpuscular haemoglobin concentration (31.8 g/dL). Conclusions: In megaloblastic anaemia,pancytopenia is a common and important clinical and haematological problem. Patients should beproperly investigated for pancytopenia and its causes because many of them are completely curablewhile others are manageable. This will help to reduce patients’ suffering, improve quality of life andprolong survival.Keywords: Pancytopenia, megaloblastic anaemia, bone marrow aspiration, acute leukaemia, aplasticanaemia, hypersplenism


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