Erişkin hematoloji polikliniğine ilk başvurusunda pansitopeni saptanan hastalarda etiyoloji
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2019
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İnönü Üniversitesi
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info:eu-repo/semantics/openAccess
Abstract
Erişkin Hematoloji Kliniğine İlk Başvurusunda Pansitopeni Saptanan Hastalarda Etiyolojik Nedenler Giriş: Pansitopeni, periferik kanda her üç seri elementin normal referans değerlerinin altında olduğu tıbbi bir durumdur. Pansitopenili olgularda destek tedavileri ile birlikte etiyolojiye yönelik tanısal çalışmalar sonucuna göre uygun tedavinin başlatılması kritik öneme sahiptir. Merkezler tarafından muhtemel etiyolojik nedenlerin bilinmesi, pansitopeni olgularının ayırıcı tanısının daha erken yapılmasına katkı sağlayabilir. Bu çalışmada, erişkin hematoloji kliniği tarafından ilk değerlendirmesinde pansitopeni saptanan hastalarda etiyolojik nedenlerin araştırılması amaçlandı. Gereç ve Yöntem: Çalışmamıza İnönü Üniversitesi Tıp Fakültesi, Erişkin Hematoloji Bilim Dalı'nda 2009 ile 2018 tarihleri arasında hematoloji polikliniğine ilk başvurusunda veya ilk konsültasyonunda pansitopeni tespit edilen hastalar alındı. Retrospektif olarak yapılan bu çalışmaya pansitopeni saptanan toplam 467 hasta alındı. Pansitopeni, hemoglobin değerinin erkeklerde <13 g/dL (kadınlarda <12 g/dL), lökosit <4 x103/microL'nin ve trombosit <150 x103/microL'nin olması şeklinde tanımlandı. Çalışmaya dahil edilen 467 pansitopenili erişkin hastanın pansitopeni nedenleri ve ilk değerlendirmedeki laboratuvar parametreleri retrospektif olarak incelendi. Bulgular: Çalışmaya retrospektif olarak pansitopeni tespit edilen 467 hasta dahil edildi. 467 hastanın 215'i (%46.0) kadın, 252'i (%54.0) ise erkekti. Hastalarımızda yaş ortalaması 56.2 ± 19.351 yıl olarak bulundu. Analizlerimize göre pansitopeni etiyolojisinde 116 (%24.8) hasta ile en sık neden megaloblastik anemi saptandı; bunu 60 (%12.8) hasta ile akut myeloblastik lösemi, 56 (%12.0) hasta ile enfeksiyon hastalıkları, 55 (%11.8) hasta ile myelodisplastik sendrom ve diğerleri izledi. Pansitopeni tespit edilerek çalışmaya alınan 467 hastanın ilk hemogram değerlendirmesinde ortalama hemoglobin değeri 8.66 ± 2.50 g/dL, lökosit sayısı 2.54 ± 0.96 x103/microL ve trombosit sayısı ise 67.88 ± 40.03 x103/microL olarak bulundu. Sonuç: Retrospektif olarak yapılan bu çalışmamızda, tanı sırasında pansitopeni saptanan hastalarda megaloblastik anemiler en sık neden olarak bulundu. Çalışmamızda akut myeloblastik lösemiler ikinci ve enfeksiyonlar ise üçünçü en sık pansitopeni nedeni olarak saptandı. Anahtar Kelimeler: Pansitopeni, Anemi, Trombositopeni, Nötropeni
Etiology of Patients with Pancytopenia at the First Application to Adult Hematology Outpatient Clinic İntroduction: Pancytopenia is a medical condition in which all three serial elements in peripheral blood are below normal reference values. In patients with pancytopenia, it is critical to initiate appropriate treatment according to the results of diagnostic studies with etiology as well as supportive treatments. Knowledge of possible etiologic causes by centers may contribute to the differential diagnosis of pancytopenic cases earlier. In this study, we aimed to investigate the etiological causes of patients with pancytopenia in the first evaluation by adult hematology clinic. Materials and Methods: Patients who were diagnosed with pancytopenia at the first presentation of the hematology outpatient clinic or in the first consultations between 2009 and 2018 were included in our study. A total of 467 patients with pancytopenia were included in this retrospective study. Pancytopenia was defined as the hemoglobin value being <13 g/dL in males (<12 g/dL in females), leukocytes <4.0 x103/microL and platelet <150 x103/microL. The causes of pancytopenia and the laboratory parameters in the first evaluation were evaluated retrospectively. Results: 467 patients with pancytopenia were included in the study retrospectively. Of 467 patients, 215 (46.0%) were female and 252 (54.0%) were male. The mean age of the patients was 56.2 ± 19.351 years. In our study the most common cause of pancytopenia was megaloblastic anemia with 116 (24.8%) patients, followed by 60 (12.8%) patients with acute myeloblastic leukemia, 56 (12.0%) with infectious diseases, 55 (11.8%) patients with myelodysplastic syndrome and the others. In the first hemogram evaluation of 467 patients diagnosed with pancytopenia, the mean hemoglobin value was 8.66 ± 2.50 g/dL, leukocyte count was 2.54 ± 0.96 x103/microL and thrombocyte count was 67.88 ± 40.03 x103/microL. Conclusion: In this retrospective study, megaloblastic anemia was found to be the most common cause in patients with pancytopenia at the time of diagnosis. In our study, acute myeloblastic leukemias were the second and infections were the third most common cause of pancytopenia. Keywords: Pancytopenia, Anemia, Thrombocytopenia, Neutropenia
Etiology of Patients with Pancytopenia at the First Application to Adult Hematology Outpatient Clinic İntroduction: Pancytopenia is a medical condition in which all three serial elements in peripheral blood are below normal reference values. In patients with pancytopenia, it is critical to initiate appropriate treatment according to the results of diagnostic studies with etiology as well as supportive treatments. Knowledge of possible etiologic causes by centers may contribute to the differential diagnosis of pancytopenic cases earlier. In this study, we aimed to investigate the etiological causes of patients with pancytopenia in the first evaluation by adult hematology clinic. Materials and Methods: Patients who were diagnosed with pancytopenia at the first presentation of the hematology outpatient clinic or in the first consultations between 2009 and 2018 were included in our study. A total of 467 patients with pancytopenia were included in this retrospective study. Pancytopenia was defined as the hemoglobin value being <13 g/dL in males (<12 g/dL in females), leukocytes <4.0 x103/microL and platelet <150 x103/microL. The causes of pancytopenia and the laboratory parameters in the first evaluation were evaluated retrospectively. Results: 467 patients with pancytopenia were included in the study retrospectively. Of 467 patients, 215 (46.0%) were female and 252 (54.0%) were male. The mean age of the patients was 56.2 ± 19.351 years. In our study the most common cause of pancytopenia was megaloblastic anemia with 116 (24.8%) patients, followed by 60 (12.8%) patients with acute myeloblastic leukemia, 56 (12.0%) with infectious diseases, 55 (11.8%) patients with myelodysplastic syndrome and the others. In the first hemogram evaluation of 467 patients diagnosed with pancytopenia, the mean hemoglobin value was 8.66 ± 2.50 g/dL, leukocyte count was 2.54 ± 0.96 x103/microL and thrombocyte count was 67.88 ± 40.03 x103/microL. Conclusion: In this retrospective study, megaloblastic anemia was found to be the most common cause in patients with pancytopenia at the time of diagnosis. In our study, acute myeloblastic leukemias were the second and infections were the third most common cause of pancytopenia. Keywords: Pancytopenia, Anemia, Thrombocytopenia, Neutropenia
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Hematoloji, Hematology
