A CLINICO- PATHOLOGICAL ANALYSIS OF PANCYTOPENIA STUDY- A 2 YEARS STUDY AT COLONIAL WAR MEMORIAL HOSPITAL.

Researchers: Kora’ai JP1, Perman ML2, Veu A3
Researcher Affiliations:
1Internal Medicine Registrar, Medical Department, Colonial War Memorial Hospital, Fiji National University, Suva, Fiji.
2Associate Professor and Internal Medicine Consultant, Fiji National University, Colonial War Memorial Hospital, Suva, Fiji.
3Consultant Physician in charge of Oncology: CWM Hospital, Suva. Fiji.
Key Words: (Pancytopenia)
Introduction: Pancytopenia is disorder in which all three formed elements are decreased in numbers (leucopenia, anemia and thrombocytopenia) below the reference level.
It is not a disease entity but a triad of findings manifested by various and diverse disease processes. Causes of Pancytopenia are largely influenced by geography, socioeconomic conditions and endemicity of certain conditions. (1, 2) Pancytopenia continues to contribute to morbidity and mortality at CWMH, Fiji. There is no published data on Pancytopenia in the Pacific in the last 15 years. This study aims to collect and document data on the incidence, cause, management and outcomes of medic al patients with Pancytopenia. A platform upon which Clinical Practice Guideline for investigations and management of patients with Pancytopenia can be developed.
Method: This is a descriptive retrospective single centered study at CWMH.
Results: The incidence of pancytopenia in the medical patients admitted at CWMH was 1.3% (13 per 1,000) with an uncorrected incidence of 1.6% (16 per 1,000). Generalized weakness, fever, shortness of breath and bleeding manifestations were the most common reasons for presentation and pallor was the most common documented physical finding, followed by Hepatomegaly and Splenomegaly. Infection (24%), End Stage Disease (19%) and Malignancy (17%) are most common etiology in the medical patients with Pancytopenia. Hence 47% of them were treated locally, 37% were offered palliative care and only 0.3% went abroad for further treatment.
Conclusion:
Infections including Salmonella typhi, Dengue fever and septicemia were the leading causes of pancytopenia in the study followed by End Stage renal disease and Systemic Lupus Erythromatosus. Most are reversible causes hence appropriate management steps must be taken to address these causes while looking for irreversible etiologies.