Clinico-haematological and management profile of aplastic anaemia--a first series of 18 cases from Nepal.
OBJECTIVE
To study the prevalence, clinico-haematological and management profile of aplastic anaemia (AA) among severely anaemic patients treated at BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal.


METHODS
A retrospective analysis of 18 cases of biopsy proven AA patients was done between September 1995 and August 1997.


RESULTS
Over a period of 2 years, 140 patients with severe anaemia were admitted to our institution. Eighteen patients were diagnosed with AA. The ages of the AA patients ranged from 7 to 56 (median 15) years, with a male: female ratio of 1.23:1. Pallor, bleeding diathesis, weakness and fever were the most common presenting complaints. Blood counts showed pancytopenia in 16 cases. Bone biopsies of all the cases were hypoplastic. Sixteen cases were non-severe AA and the remaining 2 were severe. Of the 18 cases, 16 were idiopathic; 1 case each was associated with chloramphenicol toxicity and hepatitis B infection respectively. Most of the patients were treated with corticosteroids or androgens or a combination of both. Only six patients came for regular follow-up.


CONCLUSIONS
The high (12.85%) prevalence of AA among patients admitted with severe anaemia in this hospital (which acts as a catchment area for the Eastern region) may not reflect the actual prevalence of the disease in the local community. However, a prospective study may delineate the causative factors peculiar to this region. The clinico-haematological profile is typical of the disease. However, the management profile is incomplete without a proper follow-up. This limitation may be overcome by providing free or subsidized treatment.
Sah
S P
SP
Department of Pathology, B P Koirala Institute of Health Sciences, Dharan, Nepal.
Raj
G A
GA
Rijal
S
S
Karki
P
P
D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000175:diagnosis* / Q000628:therapy; D001803:Blood Transfusion; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D015995:Prevalence