AN OBSERVATIONAL STUDY TO ASSESS THE CLINICAL PROFILES AND ETIOLOGICAL DETERMINANTS IN BICYTOPENIC PATIENTS

Abstract

Background: Blood is a vital and miraculous fluid apart from water that hosts a myriad of properties and functions that improves the overall well-being, nature and health of an individual. It is made up of erythrocytes, leucocytes, platelets and plasma that provides thermoregulation and stability to maintain various systems of the human body. Reduction of either one of the component is an indirect reflection of failing body system. One such unexplored facet is, Bicytopenia (i.e.) a reduction of erythrocytes and leukocytes in the peripheral blood. With the objective , to investigate the clinical and hematological profiles of patients with Bicytopenia and to identify its underlying etiologies. The following study was performed.

Methods: Using simple random sampling method, 150 patients were randomly selected for the study. Patients presenting with bicytopenia at over a 6 month period from admitted to Saveetha medical college and hospitals, Chennai were taken up for the study. Comprehensive clinical assessments, including detailed history, physical examination, laboratory investigations, and bone marrow evaluations when indicated, were performed. Data collected, recorded and analyzed.

Results: All ages were found to have bicytopenia, with a mean age of 31.5 years. Bicytopenia was present in Infants (< 2 years)9.12%, Children (2–12 years)7.24%, Adolescents(13–18)8.00%, Adults (19–60)63.40% and Elderly (> 61 years)12.24%. mean age was 31.5 years. Out of (n-150),60%(90)presented with fatigue as major complaint. Anemia with leukopenia (25%) and leukopenia with thrombocytopenia (12%) were the two bicytopenias that were seen most frequently.66.6% men presented with bicytopenia when compared to women. Bicytopenia was shown to have non-malignant (55%) as its most frequent etiology, followed by infectious (31.6%), malignant (8.2%), and drug-induced (3%). In the non-malignant group, immune thrombocytopenic purpura, alcoholic liver disease, and megaloblastic anemia were the most common etiologies. Dengue (11% of all infectious diseases) was the most prevalent. The hematological malignancies were most substantially linked with symptoms such lymphadenopathy, splenomegaly, and hepatomegaly (P≤ 0.005). The most prevalent non-malignant symptoms were pallor, hemorrhage, hepatomegaly, and splenomegaly (p < 0.005).

In the infectious category, fever and lymphadenopathy were most prevalent (p < 0.005).

Lymphadenopathy, hepatomegaly, and splenomegaly were the most prominent symptoms in drug induced etiology (P < 0.005).

Conclusion: Due to the diverse etiological spectrum of bicytopenia, malignancies and non-malignancies can be detected in time. Thereby, a tailored diagnostic approach and treatment  incorporating clinical evaluation and targeted investigations for effective management can be designed easily