Khattak Muhammad Bilal, Ismail Mohammad, Marwat Zahid Irfan, Khan Faramoz
J Ayub Med Coll Abbottabad. 2012 Jul-Dec;24(3-4):53-5.
A wide variety of clinical conditions, that primarily or secondarily affect the bone-marrow may present with pancytopenia, one of such conditions is megaloblastic anaemia. The purpose of this study was to determine the frequency and nature of pancytopenia in megaloblastic anaemia.
This was a prospective, cross-sectional descriptive study conducted in Medical Units, Ayub Teaching Hospital, Abbottabad, Pakistan during July 2010-January 2011. Total 90 patients were included in this study. Data were collected including history, clinical examination, haemoglobin level, mean cell volume, bone marrow examination and peripheral smear examination.
Of total 90 patients, 54 were male and 36 were female. Mean age was 28 +/- 15.84 years. Common presenting features were weakness, fever and bleeding manifestations. Pancytopenia was present in 63 (70%) patients. Most common presenting feature related to anaemia was weakness (80%). Bleeding manifestations, related to low platelet count were found in 35 (39%) patients. Physical Examination findings were: pallor (100%), splenomegaly (33%), bleeding manifestations (25%), hepatomegaly (17%), and hepatosplenomegaly (19%). Mean peripheral blood findings of the study population included haemoglobin level (6.25 g/dL), total leukocyte count (2818.7/microL), platelet count (44040/uL), and reticulocyte count (1.7%). Mean values for red cells indices included red blood cells count (2.6 million/uL), mean corpuscular volume (114.3 fL), mean corpuscular haemoglobin (27.3 pg) and mean corpuscular haemoglobin concentration (31.8 g/dL).
In megaloblastic anaemia, pancytopenia is a common and important clinical and haematological problem. Patients should be properly investigated for pancytopenia and its causes because many of them are completely curable while others are manageable. This will help to reduce patients' suffering, improve quality of life and prolong survival.
多种主要或次要影响骨髓的临床病症可能会出现全血细胞减少，巨幼细胞贫血就是其中之一。本研究的目的是确定巨幼细胞贫血中全血细胞减少的发生率和性质。
这是一项前瞻性横断面描述性研究，于2010年7月至2011年1月在巴基斯坦阿伯塔巴德阿尤布教学医院的内科病房进行。本研究共纳入90例患者。收集的数据包括病史、临床检查、血红蛋白水平、平均红细胞体积、骨髓检查和外周血涂片检查。
90例患者中，男性54例，女性36例。平均年龄为28±15.84岁。常见的临床表现为虚弱、发热和出血表现。63例（70%）患者出现全血细胞减少。与贫血相关的最常见临床表现是虚弱（80%）。35例（39%）患者出现与血小板计数低相关的出血表现。体格检查结果为：面色苍白（100%）、脾肿大（33%）、出血表现（25%）、肝肿大（17%）和肝脾肿大（19%）。研究人群外周血的平均检查结果包括血红蛋白水平（6.25g/dL）、白细胞总数（2818.7/μL）、血小板计数（44040/μL）和网织红细胞计数（1.7%）。红细胞指数的平均值包括红细胞计数（260万/μL）、平均红细胞体积（114.3fL）、平均红细胞血红蛋白（27.3pg）和平均红细胞血红蛋白浓度（31.8g/dL）。
在巨幼细胞贫血中，全血细胞减少是一个常见且重要的临床和血液学问题。应对患者进行全血细胞减少及其病因的适当检查，因为其中许多病因是完全可治愈的，而其他病因是可控制的。这将有助于减轻患者痛苦、提高生活质量并延长生存期。
