University of Khartoum

Clinical and Some Laboratory Findings in Patients with Thrombocytopenia in Khartoum State

Clinical and Some Laboratory Findings in Patients with Thrombocytopenia in Khartoum State

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Title: Clinical and Some Laboratory Findings in Patients with Thrombocytopenia in Khartoum State
Author: Hassanein, Hala Abdel Rahim Mohammed
Abstract: Background: Thrombocytopenia is commonly encountered in wide range of haematological and non-haematological disorders. As the various underlying diseases share clinical features and some laboratory findings, differential diagnosis is often a difficult interdisciplinary challenge. Bone marrow examination plays a major role in diagnosis. The aim of this study was to determine the clinical presentation and laboratory parameters including haemoglobin, total white cell count and bone marrow examination findings in patients with thrombocytopenia and accordingly establish the causes of low platelets in the studied patients. Method: This was aprospective cross sectional study, conducted in Soba Teaching Hospital from October 2013 to March 2015. A hundred and thirty eight cases were selected from patients coming for bone marrow examination with platelet count less than 150х10⁹/L, all age groups were included. Demographic and clinical data were collected from patients records and direct patient interview. Haemoglobin, total white cell and platelet count were done using automated cell counter, Sysmex KX 21. Bone marrow aspiration and trephine biopsy were done from the posterior superior iliac spine and examined under microscope. Results were analyzed using Statistic Package for Social Science, vertion19. Results: The mean age of patients was 34.9 years, males to females ratio was (1.5:1).The most common presenting symptoms were fever (32.6%), abdominal mass (31.2%) and mucocutaneous bleeding (29.5%). The most common sign was splenomegaly (52.9%), followed by hepatomegaly (47.8%), and pallor (37%), signs of skin bleeding were seen in (3.6%).Only 2.9% of the patients came with isolated thrombocytopenia.The mean haemoglobin was 7.9 gm/dl and the mean total white cell count was 14.7х10⁹/L.There was a significant relationship between platelet count and size of spleen. Most of bone marrows were hypercellular(45.7%) and normocellular(38.4%), there was a significant relationship between bone marrow cellularity and spleen size. Megakaryocyte number was adequate in most cases (45.7%).Among the 138 cases, 68 cases had abnormal cells in their aspirate, 38.6% of them had blasts, 14.7% had increased plasma cells, 14.7% had increasedhaemophagocytic activity, 13.2% had LD bodies, 7.4% had lymphocytosis, 5.9% had abnormal mononuclear cells and 4.4% had abnormal cellular aggregates. The most common diagnosis was peripheral destruction (26.1%), followed by acute leukaemia (18.1%) and plasma cell dyscriasis (7.2%). Conclusion:Bone marrow examination is mandatory to arrive at the confirmatory diagnosis of wide varieties of haematological disorders in cases of thrombocytopenia. Bone marrow examination did not diagnose idiopathic thrombocytppenia, only peripheral destruction can be reported. Correlations with clinical and peripheral blood smear findings provide variable insight in a etiology of thrombocytopenia.
URI: http://khartoumspace.uofk.edu/123456789/25007


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