Hematological manifestations of aplastic anemia in patients with hypocellular marrow presenting in a tertiary care hospital in a developing country.


  • Maham Arshad Army Medical College, Rawalpindi.
  • Fahad Ahmed Army Medical College, Rawalpindi.
  • Ayesha Ellahi Army Medical College, Rawalpindi.
  • Aiza Saadia AM College,
  • Javaid Usman AM College,
  • Saleem Ahmed NUMS, University, Rawalpindi.




Aplastic Anemia, Pure Red Cell Aplasia, Hypocellular Marrow


Objective: To see the hematological manifestations in patients with aplastic anemia presenting with hypocellular marrow. Study Design: Cross-sectional study. Setting: Department of Pathology, Pak Emirates Hospital, Rawalpindi. Period: January 2022 to June 2022. Material & Methods: Using non-probability consecutive sampling was done. All the patients were diagnosed of Aplastic anemia using standard established criteria. All the patients with hypocellular marrow without any granuloma, fibrosis or abnormal cells were included. A detailed history was taken from the patients, proforma was filled by consultants or trained doctors. Patients’ interview was followed by Bone Marrow Examination. Statistical analysis was done using SPSS version 17.0. Descriptive statistics included frequency distribution of qualitative variables and calculation of mean with range for quantitative variables was done. Limitations were a lack of molecular testing to exclude the inherited bone marrow failure syndromes. Results: A total of 247 bone marrows were done in one year which were included in the study. Out of which ten patients had aplastic anemia and one patient had pure red cell aplasia which is the early form of aplastic anemia. Frequency of aplastic anemia in our study during the study period was found to be 4.45%. Minimum age of presentation is 5 years and maximum is 78 years with mean age of 43 years. Gender distribution is as 6 were males and 5 females out of total 11 aplastic anemia patients. In haematological manifestations 7 patients presented with history of bleeding from nose and gum. While rest of the 4 patients had fever, palpitations, breathing difficulties and generalized weakness. Conclusion: As we concluded that predisposing factors like younger age group and male predominance are leading toward genetic inheritance in aplastic anemia etiology especially among the South Asian population. The most common and foremost presentation in these patients was bleeding so aplastic anemia should be excluded when patients present with bleeding, fever and palpitations., Therefore, it is far better to early diagnosis and treat the patients to minimize the disease evolution.

Author Biographies

Maham Arshad, Army Medical College, Rawalpindi.

MBBS, FCPS, Assistant Professor Pathology, 

Fahad Ahmed, Army Medical College, Rawalpindi.

MBBS, Demonstrator Pathology, 

Ayesha Ellahi, Army Medical College, Rawalpindi.

M.Phil (Hematology), Demonstrator Pathology, 

Aiza Saadia, AM College,

MBBS, M.Phil, Assistant Professor Pathology, 

Javaid Usman, AM College,

MBBS, MCPS, FCPS, Professor Pathology, 

Saleem Ahmed, NUMS, University, Rawalpindi.

MBBS, MCPS, FCPS, Professor Pathology,