Original Research

Aetiology of pancytopenia: Experience of a South African tertiary academic centre

Erica-Mari Nell, Zivanai C. Chapanduka
African Journal of Laboratory Medicine | Vol 11, No 1 | a1645 | DOI: https://doi.org/10.4102/ajlm.v11i1.1645 | © 2022 Erica-Mari Nell, Zivanai C. Chapanduka | This work is licensed under CC Attribution 4.0
Submitted: 10 June 2021 | Published: 31 May 2022

About the author(s)

Erica-Mari Nell, Division of Haematological Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
Zivanai C. Chapanduka, Division of Haematological Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa


Share this article

Bookmark and Share

Abstract

Background: Pancytopenia is a manifestation of numerous disease entities. The causes of pancytopenia differ with geographic region, socio-economic factors and HIV prevalence. Awareness of the common causes of pancytopenia may aid timely diagnosis.

Objective: This study aimed to determine the aetiology of pancytopenia in a South African population.

Methods: A retrospective observational study of adult patients presenting with pancytopenia at Tygerberg Academic Hospital, South Africa, from January 2016 to December 2017 was performed. Data on pancytopenia cases were obtained from the laboratory information system and utilised to determine the causes of pancytopenia.

Results: A total of 673 cases of pancytopenia were identified. The most common causes of pancytopenia were chemoradiation therapy (25%), sepsis (18%), haematological malignancy (9%), advanced HIV (7%), and megaloblastic anaemia (6%). The diagnostic yield of bone marrow examinations (BME) was 57% (n = 52/91). The aetiology of pancytopenia differed according to age, with malignancy being a more common cause of pancytopenia among the elderly.

Conclusion: Several easily recognisable and treatable conditions can manifest as pancytopenia. Prompt management of such conditions, notably sepsis and megaloblastic anaemia, can result in the resolution of the cytopenias and negate the need for a BME. However, haematological malignancy and unexplained pancytopenia strongly rely on a BME to establish a diagnosis. Pancytopenia investigations, when guided by appropriate clinic-laboratory findings, can promptly identify the underlying aetiology, while also identifying cases where an expedited BME is required. This is valuable in resource-conscious medicine.

 


Keywords

pancytopenia; sepsis; HIV; haematological malignancy; nutritional deficiency; megaloblastic anaemia; aging

Metrics

Total abstract views: 539
Total article views: 235

 

Crossref Citations

1. Peripheral‐blood cytopenia, an early indicator of inborn errors of immunity
Helena M. Cornelissen, Ernest M. Musekwa, Richard H. Glashoff, Monika Esser, Moleen Zunza, Deepthi R. Abraham, Zivanai C. Chapanduka
British Journal of Haematology  year: 2022  
doi: 10.1111/bjh.18337