ETIOLOGICAL SPECTRUM AND CLINICAL PROFILE OF PANCYTOPENIA IN ADULTS: A PROSPECTIVE STUDY AT A TERTIARY CARE HOSPITAL

Pancytopenia is a haematological condition, characterized by a simultaneous reduction of erythrocytes, leukocytes, and platelets in the peripheral circulation. It manifests a wide spectrum of primary disorders, including nutritional deficiencies and bone marrow failure syndromes, hematologic malignancies, thereby highlighting its heterogeneous aetiology. The diagnosis of underlying cause paramount importance, as several possible aetiologies potentially reversed. The aim of the present study was to delineate the clinical profile, etiologic distribution, and demographic features related to pancytopenia. A prospective observational design was used, in which included fifty adult participants with pancytopenia during the period of twelve months. Inclusion criteria required laboratory confirmation of pancytopenia on haematological evidence. Detailed clinical history, comprehensive physical examination and laboratory tests performed; including serum vitamin B12 levels and bone marrow evaluation through aspirate or biopsy. Participants younger than 30 years, majority of the cohort at 52 % and males accounted 64%. The most frequently reported clinical manifestation were fatigue (96%) and dyspnoea (94%), and followed by fever in 42% of cases. Pallor was presented among all the participants, with additional clinical features of knuckle hyperpigmentation (20%), hepato-splenomegaly (16%), and jaundice (14%). Etiologic analysis revealed that megaloblastic anemia (48%) was the most significant cause of pancytopenia, followed by infectious processes, hypersplenism, acute leukaemia, and aplastic anemia. Notably, 62.5% of megaloblastic anemia was found to have serum vitamin B12 deficiency. The findings underscore that megaloblastic anemia as the predominant aetiology of pancytopenia. Consequently, clinical evaluation combined with targeted lab investigations is essential for accurate diagnosis. Such a method allows early identification of reversible causes, which eventually enabling timely intervention and enhances patient outcomes.