Pancytopenia: A severe complication of miliary tuberculosis

Objective.- To analyze the epidemiology, clinical features and outcome of patients with hematologic abnormalities in miliary tuberculosis. Methods.- This was a retrospective study in the pneumology department of the University hospital in Abidjan (RCI), between January 2000 and December 2009. We analyzed the medical records of patients with pancytopenia occurring in the context of miliary tuberculosis. We compared the clinical characteristics and the outcome in patients with pancytopenia versus patients without pancytopenia. Results.- Pancytopenia occurred in 12% of patients with miliary tuberculosis; 11 men (61%) and seven women (39%). The average age of patients was 33 years, [17-67 years]. Pancytopenia with miliary tuberculosis was frequently associated with HIV: 92.8% (P = 0.0009). The clinical characteristics were: fever (88.9%), severe weight loss: 100% vs. 78.8% MT without pancytopenia (P = 0.025), respiratory distress: 100% vs. 52.3% MT without pancytopenia (P = 0.00032), splenomegaly: 77.8% vs. 5.30% MT without pancytopenia (P = 0.0000), multiple lymph nodes: 66.7% vs. 29.5% MT without pancytopenia (P = 0.0043). The occurrence of pancytopenia in military TB is associated with a bad prognosis and the outcome was unfavorable in 8.33% (P = 0.00001). Conclusion.- Patients with pancytopenia in miliary tuberculosis have a high mortality despite tuberculosis treatment. © 2012 Elsevier Masson SAS. All rights reserved.