Determination of Etiological Factors associated with Aplastic Anaemia in Rahim Yar Khan District of Southern Punjab

Abstract

Objective: To determine the clinico-haematological profile and etiological factors of aplastic
anaemia in patients under study.
Material & Methods: This cross sectional study was conducted on 34 aplastic anaemic
patients in the department of Department of Haematology and Blood Transfusion, Sheikh Zayed
Medical College/Hospital, Rahim Yar Khan with cases referred from medicine, pediatric and out
patients departments over a period of 22 months from October 2008 to July 2010. Patients of all
ages and sex were included in the study. Data was entered into SPSS version 15 and analyzed
descriptively.
Results: Results depict that most of the patients were in the age range 5-35 years with mean±
SD (22.18±9.107 years). 82.35% patients were males and 17.65% were females. Out of 34 cases
diagnosed as aplastic anaemia, 30 cases (88.2%) were suffering from acquired aplastic anemia
while 4 (11.7%) cases were found to have inherited aplastic anaemia (Fanconi Anaemia). Out of
34 patients with acquired aplastic anemia, 23 (67.6%) patients had drug induced marrow
hypoplasia with major marrow suppressant effect produced by chloramphenicol and sulfa
formulated drugs in 14 (60.87%). 9 (39.13%) patients used non-steroidal anti-inflammatory drugs
particularly Indomethacin and heavy metals incorporated in herbal medicines. Only 4 cases
(11.8%) were diagnosed as inherited aplastic anaemia with major clinical manifestations in the
form of hyperpigmentation of skin, short stature and hypoplastic thenar eminences. Interestingly
there was not a single patient with positive viral serological profile (e.g HCV, HBsAg, HIV etc).
Conclusion: Majority of the studied patients had acquired aplastic anaemia. Antibiotics
particularly Sulfonamides & Chloramphenicol, non steroidal anti-inflammatory drugs, gold salts
and non-specified heavy metals are important causes of bone marrow suppression.