Frequency of Pancytopenia among Patients with Vitamin B12 Deficiency

Abstract: Background: B12 deficiency is a common yet nutritional ailment prevalent among the aged ages of sixty years and above and amongst women. Major hematological result with vitamin B12 deficit is pancytopenia (PCP) which is reversible in most cases with an early treatment. The paucity of local data with regard to the incidence of PCP among the vitamin B12 deficient patients highlights the fact that, additional research is required. Objective: To evaluate the frequency of pancytopenia in patients with vitamin B12 deficiency. Materials and Methods: A descriptive cross-sectional study of 270 patients (18-60 years old) was conducted in Saidu Group of Teaching Hospitals, Swat, Pakistan, between July and December 2024 to study vitamin B12 deficiency in patients. A patient with a <150 pmol/L serum vitamin B12 level was considered vitamin B12 deficient. The presence or absence of PCP was marked on the peripheral smear of blood, i.e., hemoglobin<10 g/dL, total leucocyte count <4,000/µL, platelets<150,000/µL, and reticulocyte count<2%. Chi-square test was applied to see the association of PCP with demographic and clinical variables among patients with vitamin B12 deficiency, taking p<0.05 as significant. Result: In a total of 270 patients, 160 (59.3%) were male, and 110 (40.7%) female. The mean age, and BMI were 35.4±10.1 years, and 25.5±3.6 kg/m2, respectively. Residential status of 156 (57.8%) was urban. Diabetes mellitus was diagnosed in 46 (17.0%) patients. The mean vitamin B12 levels was 110.4±18.9 pmol/L. The frequency of PCP was noted in 57 (21.1%) patients. Stratification of PCP with respect to gender, age groups, BMI categories, residential status, diabetes melitus, and smoking status did not reveal any significant associations (p>0.05). Conclusion: The frequency of PCP was high in adult patients with vitamin B12 deficiency. Keywords: Anemia, Pancytopenia, Hemoglobin, Red cell count, Mean corpuscular volume, Vitamin B12 deficiency.