The purpose of this study of patients with
pancytopenia in Republic of Djibouti was to identify etiologic factors and attempt to define diagnostic and therapeutic strategies adapted to local conditions. Clinical, biological and radiological assessment was performed in 81 patients hospitalized for
pancytopenia. There were 56 men and 25 women. Mean
hemoglobin, leukocyte and platelet rates were 56,5 +/- 22,7 g/l, 2,1 +/- 0,7.g/l and 56,2 +/- 24,7 g/l respectively.
Vitamin deficiency was the most common cause of
pancytopenia (49%), followed by
hypersplenism (9%),
HIV infection (6%) and
leishmaniasis (6%).
Vitamin-deficient patients had significantly more severe
anemia and
thrombopenia and significantly higher mean corpuscular volume than patients with
pancytopenia related to other causes.
Hemoglobin rate lower than 40 g/L and platelet rate lower than 35 G/L showed a positive predictive values of 90% and 100% respectively for a
vitamin deficient
pancytopenia.
Vitamin deficiency is the most frequent etiology of
pancytopenia and causes the most severe
cytopenia in Djibouti. Rapid
vitamin supplementation after minimal etiologic assessment including a myelogram is an effective treatment strategy for this public health problem.