A Comprehensive Analysis of Clinical Presentations, Laboratory Findings, and Etiologies of Pancytopenia: A Tertiary Care Experience.

Background Pancytopenia, while a common manifestation of a multitude of diseases, remains a relatively lesser-researched topic, especially in developing countries. Its management depends largely on identifying the etiology, which can range from simple infections to more sinister causes like leukemia. This study aims to investigate the clinical presentations, hematological findings, and etiologies of pancytopenia in a developing country. Methods A cross-sectional study was conducted at Hayatabad Medical Complex, Peshawar, and included 106 patients who were diagnosed with pancytopenia. Thorough demographic details, histories, clinical examinations, laboratory investigations, bone marrow biopsies, and final diagnoses were recorded and analyzed using statistical tools. Results Pancytopenia was most common in the age group 11-30 years with a male-to-female ratio of 1.4:1. Infections were the leading etiology (17.9%), followed by megaloblastic anemia (17%), hypersplenism (16%), and malignancy (15.1%). Among infections, enteric fever was the most frequently observed cause. The most common presentation was with signs and symptoms of anemia, followed by infections and thrombocytopenia. The most common blood smear finding case-wise was a combination of anisocytosis, microcytosis, and target cells. In patients who underwent bone marrow biopsy, the commonest finding (34%) was suggestive of malignancy with hypercellularity and abnormal cells. Aplastic anemia, hypersplenism, and malignancy were associated with a retic count of <1.5%. Platelet counts of less than 50,000 were associated with the presence of signs and symptoms of thrombocytopenia. Conclusion Pancytopenia can be a presenting feature of a reversible condition like underlying infection and megaloblastic anemia, which contribute a major portion of its etiologies. Early diagnosis and treatment can reverse pancytopenia and prevent over-investigation.