title: Pancytopenia in Zimbabwe.
abstract: BACKGROUND
  There has been little systematic study of the clinical spectrum of pancytopenia, and the optimal diagnostic approach to pancytopenia remains undefined.
  
  
  METHODS
  The authors studied 134 hospitalized pancytopenic patients in Zimbabwe in both consecutive and nonconsecutive fashion.
  
  
  RESULTS
  The most common cause of pancytopenia was megaloblastic anemia, followed by aplastic anemia, acute leukemia, acquired immunodeficiency syndrome (AIDS), and hypersplenism. Severe pancytopenia was usually due to aplastic anemia. Patients with aplastic anemia and acute leukemia were usually children, whereas those with megaloblastic anemia were adults. Moderate to severe anemia was noted throughout the series, but was most striking in patients with megaloblastic anemia, aplastic anemia, and acute leukemia. The mean corpuscular volume (MCV) was elevated in most patients with megaloblastic hematopoiesis, aplastic anemia, and acute nonlymphocytic leukemia. Normal or low MCV values were noted in almost one third of patients with megaloblastic anemia. Anisocytosis, poikilocytosis, macroovalocytosis, microcytosis, fragmentation, and teardrop erythrocytes were more prominent on the blood films of patients with megaloblastic anemia.
  
  
  CONCLUSIONS
  Megaloblastic anemia, aplastic anemia, and AIDS are the most common causes of pancytopenia in Zimbabwe. Aplasia is the most frequent cause of severe pancytopenia. The authors have formulated tentative guidelines for the evaluation of pancytopenic patients in this setting.
authors.affiliation: Department of Haematology, University of Zimbabwe School of Medicine, Harare. savage@cuccfa.ccc.columbia.edu
authors.forename: D G
authors.initials: DG
authors.lastname: Savage
authors.forename: R H
authors.initials: RH
authors.lastname: Allen
authors.forename: I T
authors.initials: IT
authors.lastname: Gangaidzo
authors.forename: L M
authors.initials: LM
authors.lastname: Levy
authors.forename: C
authors.initials: C
authors.lastname: Gwanzura
authors.forename: A
authors.initials: A
authors.lastname: Moyo
authors.forename: B
authors.initials: B
authors.lastname: Mudenge
authors.forename: C
authors.initials: C
authors.lastname: Kiire
authors.forename: J
authors.initials: J
authors.lastname: Mukiibi
authors.forename: S P
authors.initials: SP
authors.lastname: Stabler
authors.forename: J
authors.initials: J
authors.lastname: Lindenbaum
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000741:Anemia, Aplastic / Q000150:complications; D000749:Anemia, Megaloblastic / Q000150:complications; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006971:Hypersplenism / Q000150:complications; D007223:Infant; D007938:Leukemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015030:Zimbabwe