MEGALOBLASTIC ANAEMIA THE COMMONEST CAUSE OF PANCYTOPENIA IN ADULT POPULATION, A DESCRIPTIVE STUDY IN A TERTIARY CARE CENTER

Background Pancytopenia is defined as reduction of all three formed elements blood like Rbcs,Wbcs and platelets below the normal reference ranges. It is the manifestation of a number of disease processes affecting the bone marrow. Aim to identify the various causes of pancytopenia in adult population by bone marrow examination, then the most common cause of pancytopenia and to find the frequency the most common cause of pancytopenia in relation to age and sex. This is two years description study. Methods Peripheral smears, buffy coat smears, marrow aspiration smears and trephine biopsies of thirty six cases were studied. Special stain done for suspicious cases of leukemia and lymphoma. Relevant clinical history and investigations were collected. Peadiatric cases and patients on chemotherapy were excluded from this study. Results Megaloblastic anaemia was the most common cause of Pancytopenia followed by Aplastic anaemia. Female are more common than male. Common among elderly population in their sixth decade. Peripheral smear showed characteristic features like macrocytes, macroovalocytes and hypersegmented neutrophils. Erythroid hyperplasia was seen in 18 cases of megaloblastic anaemia. Both peripheral smear and  bone marrow findings were statistically significant. Conclusion Bone marrow aspiration and trephine biopsy are mandatory for the diagnosis of the various causes of pancytopenia. Macroovalocytes and hypersegmented neutrophils in peripheral smear, erthyroid hyperplasia with megaloblastic maturation helps in definitive diagnosis of Megaloblastic anaemia. Comprehensive clinical and hematological study on pancytopenia cases is needed to identify the cause with certainty.