Objectives: Increasing number of patients present now a days with pancytopeniadue to B12 and folic acid deficiencies, bone marrow failures and hypersplenism. The changing diet, lifestyle, and environment could be the cause for the increased incidence. It is important to have a clinical diagnosis at presentation itself, to identify and treat the potentially correctable causes of pancytopenia like vitamin B12 deficiency. The present study was to look into the correlation between clinical diagnosis and final diagnosis; and also to study the clinical profile, etiological factors,and treatment response in the subgroup of patients diagnosed to have B12/folate deficiency. Methods: It was a cross-sectional study involving 65patients in one year. Their clinical diagnosis (made after history, physical examination and hemogram) was compared with the final diagnosis. The subgroup of patients diagnosed to have B12/folate deficiency was studied in detail for their clinical profile & etiological factors. Results: There was a statistically significant correlation between clinical & final diagnosis. Sensitivity of clinical diagnosis was highest (93%) for B12/folate deficiency. Diet history, knuckle pigmentation, glossitis and MCV>100fl had a statistically significant association with B12/folate deficiency. Conclusions: B12/folate deficiency and acute leukemia were the commonest causes for pancytopenia. Sensitivity of clinical and pathological diagnoses of B12 deficiency was 93% and 73% respectively. Hence high clinical suspicion is mandatory for diagnosis of vitamin B12 deficiency. The diagnosis of vitamin B12/folate deficiency can be predicted using the dietary history, knuckle pigmentation, glossitis and MCV>100fl.

Keywords: Pancytopenia; B12 Deficiency; Folic Acid Deficiency; ClinicoPathological Correlation.