Farooque Rabia, Iftikhar Sundus, Herekar Fivzia, Patel Muhammad Junaid
Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK.
Internal Medicine, The Indus Hospital, Karachi, PAK.
Cureus. 2020 Oct 20;12(10):e11057. doi: 10.7759/cureus.11057.
Introduction Pancytopenia is an important hematologic problem encountered frequently in clinical practice characterized by a reduction in all three peripheral blood cell lineages, i.e., anemia, leucopenia, and thrombocytopenia, caused by myriad disease processes. Our study aimed to determine the frequency and etiology of pancytopenia in patients admitted under internal medicine services in a tertiary care hospital. Method This cross-sectional study was conducted in the in-patient internal medicine department, The Indus Hospital (TIH), Karachi, included 258 patients. To be eligible, participants had to give informed consent, be 14 years or older, and of either sex. The study involved a 20-30-minute interaction with the patient, involving an interview and physical examination, and access to electronic health record data. Results Out of 258 patients studied, 24 (9.3%) were diagnosed with pancytopenia, the male to female ratio was 1:1, no significant difference was observed in the proportion of ethnicity, religion, previous treatment, known infectious disease, and personal and occupational exposure among pancytopenic patients and other non-pancytopenic patients. Fever (n=14, 58.3%) was most common presenting complaint followed by fatigue (n=13, 54.2%) and weight loss (n=7, 29.2%) while most common signs were pallor (87.5% n=21), hepatomegaly (29.2%, n=7), and splenomegaly (25%, n=6). The most common cause of pancytopenia was megaloblastic anemia (n=10, 41.7%), followed by hypersplenism (n=4, 16.6%), acute infectious diseases (n=3, 12.5%), and autoimmune diseases (n=3, 12.5%). Conclusion Our study suggests that pancytopenia is a common finding among our patient population and a larger proportion has a treatable cause, thus carrying a favorable prognosis.
引言
全血细胞减少是临床实践中经常遇到的一个重要血液学问题,其特征是外周血的所有三种血细胞谱系减少,即贫血、白细胞减少和血小板减少,由多种疾病过程引起。我们的研究旨在确定一家三级护理医院内科收治患者中全血细胞减少的发生率和病因。
方法
这项横断面研究在卡拉奇的印度河医院内科住院部进行,纳入了258名患者。符合条件的参与者必须签署知情同意书,年龄在14岁及以上,性别不限。该研究包括与患者进行20至30分钟的互动,包括访谈和体格检查,并获取电子健康记录数据。
结果
在研究的258名患者中,24名(9.3%)被诊断为全血细胞减少,男女比例为1:1,全血细胞减少患者与其他非全血细胞减少患者在种族、宗教、既往治疗、已知传染病以及个人和职业暴露比例方面未观察到显著差异。发热(n = 14,58.3%)是最常见的主诉,其次是疲劳(n = 13,54.2%)和体重减轻(n = 7,29.2%),而最常见的体征是苍白(87.5%,n = 21)、肝肿大(29.2%,n = 7)和脾肿大(25%,n = 6)。全血细胞减少最常见的原因是巨幼细胞贫血(n = 10,41.7%),其次是脾功能亢进(n = 4,16.6%)、急性传染病(n = 3,12.5%)和自身免疫性疾病(n = 3,12.5%)。
结论
我们的研究表明,全血细胞减少在我们的患者群体中是一个常见发现,且较大比例的患者病因可治,因此预后良好。