132 Pak J Med Sci 2010 Vol. 26 No. 1 www.pjms.com.pk Original Article PANCYTOPENIA: MEGALOBLASTIC ANEMIA IS STILL THE COMMONEST CAUSE Tariq Aziz 1 , Liaquat Ali 2 , Tahir Ansari 3 , Hammad Bin Liaquat 4 , Shahnaz Shah 5 , Jamal Ara 6 ABSTRACT Objectives: To find out the frequency of the different causes of Pancytopenia and also to specifically detect the percentage of vitamin B 12 deficieny amongst these patients. Methodology: It is a prospective study carried out in Medical Unit I (Ward 5) of Jinnah Postgraduate Medical Centre Karachi from March to August 2007. A total of 88 patients were included after a detailed history and examinations the information was recorded on Proforma. Findings of aspiration and trephine biopsies were interpreted in the light of history, clinical examination and peripheral blood findings. Result s: Out of 88 patients suffering from Pancytopenia, a large number (40.90%) were diagnosed as Megaloblastic Anemia, out of which 77.77 % had vitamin B12 deficiency. Aplastic anemia was found in 28 (31.88%) patients followed by other less common causes. Conclusion: Megaloblastic anemia was found in largest number of patients who were found to have Pancytopenia on initial investigations and majority of such patients were found to be deficient in Vitamin B 12 . KEY WORDS: Pancytopenia, Megaloblastic Anemia, Vitamin B 12 deficiency. Pak J Med Sci January - March 2010 Vol. 26 No. 1 132-136 How to cite this article: Aziz T, Ali L, Ansari T, Liaquat HB, Shah S, Ara J. Pancytopenia: Megaloblastic anemia is still the commonest cause. Pak J Med Sci 2010;26(1):132-136 1. Dr. Tariq Aziz, FCPS Senior Registrar, 2. Dr. Liaquat Ali, FCPS Associate Professor, 3. Dr. Tahir Ansari, FCPS Senior Registrar, 4. Dr. Hammad Bin Liaquat, MBBS House Officer/ Intern 5. Dr. Shahnaz Shah, FCPS Senior Registrar, 6. Dr. Jamal Ara, FCPS Professor of Medicine & In charge, 1-6: Ward-5 (Medical Unit-I), Department of Medicine, Jinnah Postgraduate Medical Centre (JPMC), Karachi - 75500, Pakistan. Correspondence Dr. Tariq Aziz, FCPS E-mail: liaquat.ali1953@yahoo.com * Received for Publication: July 24, 2009 * Revision Received: November 12, 2009 * Revision Accepted: November 13, 2009 INTRODUCTION Cytopenia is a reduction in the number in any of the three types of peripheral blood cell. A reduction in all three types of cellular compo- nents is termed pancytopenia and this involves anemia, leucopoenia, and thrombocytopenia. 1 Initially, mild impairment in marrow function may go undetected and pancytopenia may be- come apparent only during times of stress or increased demand (e.g., bleeding or infection). As severity increases, the peripheral blood count decreases even in the steady state. The basic investigations in a suspected case of pan- cytopenia include Complete Blood Count with peripheral blood film and Reticulocyte count. In peripheral film, blast cells may be evident in patients where pancytopenia is due to malignant infiltration. Neutrophils might show