Araştırma Makalesi
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Etiological evaluation in 766 patients with pancytopenia; a single center experience

Yıl 2020, , 165 - 169, 01.06.2020
https://doi.org/10.21601/ortadogutipdergisi.570341

Öz

Aim: Pancytopenia is a clinical problem which has a wide differential diagnostic spectrum and may occur with various mechanisms. In this study we aimed to determine the most common etiologic causes in patients with pancytopenia.
Materials and Methods: The records of patients aged 18 years and older, who applied to the Health Sciences University Bakirkoy Dr. Sadi Konuk Training and Research Hospital between 2012 and 2017 and who were diagnosed with pancytopenia according to World Health Organization (WHO) criteria were retrospectively reviewed. Statistical Method: Mann-Whitney-U test was used for 2 groups and Kruskal-Wallis test was applied for 3 and more groups. Since no normal distribution was provided as a descriptive statistic, median and change interval values were given for continuous data.
Results: A total of 766 patients, 475 (62%) women and 291(38%) men, were included in the study. In these patients, non-hematologic causes were found in 77.7% and hematologic causes in 22.3% of patients with pancytopenia. Hematological etiologies were 72.2% benign and 27.8% malignant. Non-hematological causes were divided into groups as renal diseases (6.05%), rheumatological diseases (2.3%), infective diseases (10.7%), endocrinological diseases (3.8%), hypersplenism (14.4%), immunosuppressive drug use (17.4%), solid organ cancers (10.7%) and unidentified reasons (34.2%).
Conclusion: Pancytopenia should be evaluated carefully and the etiology should be detected quickly and corrected by appropriate treatment. It is an appropriate approach to exclude, firs the non-hematological causes (especially immunosuppressive drug use, hypersplenism, infection and solid organ cancers) and the benign causes of hematological reasons. 

Kaynakça

  • Valent P. Low blood counts: immune mediated, idiopathic, or myelodysplasia. Hematology Am Soc Hematol Educ Program 2012; 2012: 485-91.
  • Young NS, Abkowitz JL, Luzzatto L. New insights into the pathophysiology of acquired cytopenias. Hematology Am Soc Hematol Educ Program 2000: 18-38.
  • Pascutti MF, Erkelens MN, Nolte MA. Impact of viral infections on hematopoiesis: from beneficial to detrimental effects on bone marrow output. Front Immunol 2016; 7(364): 1-12.
  • Marks PW. Hematologic manifestations of liver disease. Seminars in hematology 2013; 50: 216-21.
  • Risitano AM, Maciejewski JP, Selleri C, Rotoli B. Function and malfunction of hematopoietic stem cells in primary bone marrow failure syndromes. Curr Stem Cell Res Ther. 2007; 2(1): 39-52.
  • Savage DG, Allen RH, Gangaidzo IT, Levy LM, Gwanzura C, Moyo A, et al. Pancytopenia in Zimbabwe. Am J Med Sci 1999; 317(1): 22-32.
  • Tilak V, Jain R. Pancytopenia - A Clinico hematologic analysis of 77 cases. Indian J Pathol Microbiol 1999; 42(4): 399-404.
  • Imbert M, Scoazec JY, Mary JY, Jouzult H, Rochant H, Sultan C. Adult patients presenting with pancytopenia: a reappraisal of underlying pathology and diagnostic procedures in 213 cases. Hematol Pathol 1989; 3(4): 159-67.
  • Khodke K, Marwah S, Buxi G, Yadav RB, Chaturvedi NK. Bone marrow examination in cases of pancytopenia. J Indian Acad Clin. Med 2001; 2: 55-9.
  • Gayathri BN, Rao KS. Pancytopenia: a clinico hematological study. J Lab Physicians 2011; 3(1): 15-20.
  • Premkumar M, Gupta N, Singh T, Velpandian T. Cobalamin and folic Acid status in relation to the etiopathogenesis of pancytopenia in adults at a tertiary care centre in north India. Anemia 2012; 2012: 707402.
  • Hayat AS, Khan AH, Baloch GH, Shaikh N. Pancytopenia; study for clinical features and etiological pattern of at tertiary care settings in Abbottabad. Professional Med J 2014; 21(1): 060-065.
  • Yadav BS, Varma A, Kiyawat P. Clinical profile of pancytopenia: a tertiary care experience. Int. J. Bioassays 2015; 4(01): 3673-3677.
  • Dubey TN, Nigotia P, Saxena R. The Common Causes Leading to Pancytopenia in Patients Presenting in Hospital of Central India. International Journal of Contemporary Medical Research 2016; 3(10): 3027-3030.

Pansitopenisi olan 766 hastada etyolojik değerlendirme; tek merkez deneyimi

Yıl 2020, , 165 - 169, 01.06.2020
https://doi.org/10.21601/ortadogutipdergisi.570341

Öz

Amaç: Pansitopeni, çeşitli mekanizmalarla ortaya çıkabilen ve geniş bir ayırıcı tanı spektrumuna sahip klinik bir problemdir. Bu çalışmada pansitopenili hastalarda en sık görülen etiyolojik nedenleri belirlemeyi amaçladık.
Gereç ve Yöntem: Sağlık Bilimleri Üniversitesi Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi’ne 2012-2017 yılları arasında başvuran ve Dünya Sağlık Örgütü kriterlerine göre pansitopeni tanısı alan 18 yaş ve üstü hastaların kayıtları retrospektif olarak incelendi.
İstatistiksel Yöntem: İkili gruplara Mann-Whitney-U testi, 3 ve daha fazla grubun olduğu karşılaştırmalarda ise Kruskal-Wallis testi uygulandı. Tanımlayıcı bir istatistik olarak normal dağılım sağlanmadığından, sürekli veriler için ortanca ve değişim aralığı değerleri verildi. Bulgular: Çalışmaya 475 (%62) kadın ve 291 (%38) erkek olmak üzere toplam 766 hasta dahil edildi. Bu hastaların %77,7’sinde hematolojik olmayan nedenler, %22,3’ünde ise hematolojik nedenlerin pansitopeni etiyolojisinde rol oynadığı görüldü. Hematolojik etiyolojilerin %72,2’si benign, %27,8’i ise malign hastalıklardan oluşmaktaydı. Hematolojik olmayan nedenlerin ise; renal (%6,05), romatolojik hastalıklar (%2,3), enfektif hastalıklar (%10,7), endokrinolojik hastalıklar (%3,8), hipersplenizm (%14,4), immünsupresif ilaç kullanımı (%17,4), solid organ kanserleri (%10,7) ve tanımlanamayan nedenler (%34,2)’den oluştuğu görüldü.
Sonuç: Pansitopeni dikkatlice değerlendirilerek etiyolojisi hızlı bir şekilde tespit edilmeli ve uygun tedavi ile düzeltilmelidir. Öncelikle hematolojik olmayan nedenlerin (özellikle immünsupresif ilaç kullanımı, hipersplenizm, enfeksiyon ve solid organ kanserleri) ve hematolojik nedenlerden de benign hastalıkların dışlanması uygun bir yaklaşımdır.

Kaynakça

  • Valent P. Low blood counts: immune mediated, idiopathic, or myelodysplasia. Hematology Am Soc Hematol Educ Program 2012; 2012: 485-91.
  • Young NS, Abkowitz JL, Luzzatto L. New insights into the pathophysiology of acquired cytopenias. Hematology Am Soc Hematol Educ Program 2000: 18-38.
  • Pascutti MF, Erkelens MN, Nolte MA. Impact of viral infections on hematopoiesis: from beneficial to detrimental effects on bone marrow output. Front Immunol 2016; 7(364): 1-12.
  • Marks PW. Hematologic manifestations of liver disease. Seminars in hematology 2013; 50: 216-21.
  • Risitano AM, Maciejewski JP, Selleri C, Rotoli B. Function and malfunction of hematopoietic stem cells in primary bone marrow failure syndromes. Curr Stem Cell Res Ther. 2007; 2(1): 39-52.
  • Savage DG, Allen RH, Gangaidzo IT, Levy LM, Gwanzura C, Moyo A, et al. Pancytopenia in Zimbabwe. Am J Med Sci 1999; 317(1): 22-32.
  • Tilak V, Jain R. Pancytopenia - A Clinico hematologic analysis of 77 cases. Indian J Pathol Microbiol 1999; 42(4): 399-404.
  • Imbert M, Scoazec JY, Mary JY, Jouzult H, Rochant H, Sultan C. Adult patients presenting with pancytopenia: a reappraisal of underlying pathology and diagnostic procedures in 213 cases. Hematol Pathol 1989; 3(4): 159-67.
  • Khodke K, Marwah S, Buxi G, Yadav RB, Chaturvedi NK. Bone marrow examination in cases of pancytopenia. J Indian Acad Clin. Med 2001; 2: 55-9.
  • Gayathri BN, Rao KS. Pancytopenia: a clinico hematological study. J Lab Physicians 2011; 3(1): 15-20.
  • Premkumar M, Gupta N, Singh T, Velpandian T. Cobalamin and folic Acid status in relation to the etiopathogenesis of pancytopenia in adults at a tertiary care centre in north India. Anemia 2012; 2012: 707402.
  • Hayat AS, Khan AH, Baloch GH, Shaikh N. Pancytopenia; study for clinical features and etiological pattern of at tertiary care settings in Abbottabad. Professional Med J 2014; 21(1): 060-065.
  • Yadav BS, Varma A, Kiyawat P. Clinical profile of pancytopenia: a tertiary care experience. Int. J. Bioassays 2015; 4(01): 3673-3677.
  • Dubey TN, Nigotia P, Saxena R. The Common Causes Leading to Pancytopenia in Patients Presenting in Hospital of Central India. International Journal of Contemporary Medical Research 2016; 3(10): 3027-3030.
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma makaleleri
Yazarlar

Betül Erişmiş 0000-0003-2970-2076

Gamze Gulcıcek Bu kişi benim 0000-0002-7498-8846

Medine Şişman 0000-0002-5135-1690

Betul Yıldırım Ozturk Bu kişi benim 0000-0001-6175-8964

Deniz Yılmaz Bu kişi benim 0000-0001-9870-5305

İtır Şirinoğlu Demiriz 0000-0001-7931-7104

Yayımlanma Tarihi 1 Haziran 2020
Yayımlandığı Sayı Yıl 2020

Kaynak Göster

Vancouver Erişmiş B, Gulcıcek G, Şişman M, Yıldırım Ozturk B, Yılmaz D, Şirinoğlu Demiriz İ. Etiological evaluation in 766 patients with pancytopenia; a single center experience. otd. 12(2):165-9.

e-ISSN: 2548-0251

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