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埃塞俄比亚一家三级医院收治的成年患者不明原因全血细胞减少症:病例系列

Pancytopenia of Unknown Cause in Adult Patients Admitted to a Tertiary Hospital in Ethiopia: Case series.

作者信息

Gudina Esayas Kebede, Amare Hiwot, Benti Kasahun, Ibrahim Shoba, Mekonnen Gashahun

机构信息

Department of Internal Medicine, Jimma University, Jimma.

出版信息

Ethiop J Health Sci. 2018 Jul;28(4):375-382. doi: 10.4314/ejhs.v28i4.3.

Abstract

BACKGROUND

Over the past few years, we have witnessed a dramatic increase in the number of patients presenting with severe pancytopenia to Jimma University Hospital. We now present sociodemographic and clinical characteristics of adult patients admitted with pancytopenia of unknown cause to Jimma University Hospital during the period of March 2015 to June 2016. Complete blood count and other diagnostic tests were done for all patients to uncover underlying causes.

RESULT

Out of 65 cases admitted with pancytopenia during the specified period, 40 were excluded for various reasons. The rest 25 patients were included in this review. The mean age was 32.1 years (SD=14.9); 14 were younger than 30 years of age. The mean hemoglobin level, white cell count and platelet count were 48.6 g/L (SD=1.9), 1,918 /µL (SD=879.8) and 36,200 /µL (SD=26,131) respectively. The major presenting symptoms were generalized malaise and fever. No geographic or seasonal clustering of the cases was seen.

CONCLUSION

The number of cases with pancytopenia of unidentified cause seen at the hospital over the specified period is alarmingly high and deserves great attention. The hematologic alteration in most of the patients was found to be severe with poor clinical outcome. This calls for large scale community based investigation to uncover the root cause of the problem.

摘要

背景

在过去几年中,我们目睹了吉马大学医院出现严重全血细胞减少症的患者数量急剧增加。我们现在呈现2015年3月至2016年6月期间因不明原因全血细胞减少症入住吉马大学医院的成年患者的社会人口统计学和临床特征。对所有患者进行了全血细胞计数和其他诊断测试,以发现潜在病因。

结果

在指定期间因全血细胞减少症入院的65例病例中,40例因各种原因被排除。其余25例患者纳入本综述。平均年龄为32.1岁(标准差=14.9);14例年龄小于30岁。平均血红蛋白水平、白细胞计数和血小板计数分别为48.6 g/L(标准差=1.9)、1918 /µL(标准差=879.8)和36200 /µL(标准差=26131)。主要表现症状为全身不适和发热。未发现病例的地理或季节聚集情况。

结论

在指定期间医院中出现不明原因全血细胞减少症的病例数量高得惊人,值得高度关注。发现大多数患者的血液学改变严重,临床结局不佳。这需要进行大规模的社区调查以查明问题的根源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ed1/6308738/39280ed71199/EJHS2804-0375Fig1.jpg

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