Etiological Spectrum and Clinical Profile of Thrombocytopenia Patients Undergoing Bone Marrow Biopsy in a Tertiary Care Center in North India: A Cross-sectional Study

Background and Aim: Thrombocytopenia, defined as a platelet count below 150 × 10 3 /µL, is a common hematological condition with diverse etiologies ranging from benign nutritional deficiencies to serious malignancies. In the Kashmir region, the burden of nutritional anemia has been suggested as a major contributor, necessitating regional studies for tailored diagnostic and management strategies. The aim of this study was to evaluate the etiological spectrum and clinical profile of thrombocytopenia in patients undergoing bone marrow examination at a tertiary care hospital in Kashmir. Materials and Methods: This cross-sectional study included 266 patients with thrombocytopenia who underwent bone marrow examination at Government Medical College, Srinagar. Demographic, clinical, and laboratory data were collected, and etiologies were determined based on bone marrow findings and supporting investigations. Statistical analysis was performed using SPSS v20.0. Results: The mean age of patients was 45.1 ± 20.34 years, with a slight male predominance. Pallor (76.3%) and generalized weakness (75.6%) were the most common presenting symptoms. Pancytopenia was the predominant hematological pattern (69.2%). The most frequent etiologies identified were megaloblastic anemia (27.1%), dual deficiency anemia (18.4%), acute leukemia (13.2%), and immune-mediated platelet destruction (11.3%). Bone marrow examination revealed hypercellularity in 65% of cases, normocellularity in 29.7%, and hypocellularity in 5.3%. A statistically significant correlation was found between marrow cellularity and underlying etiology ( P < 0.001). Conclusion: Nutritional deficiencies, especially megaloblastic anemia, are the leading causes of thrombocytopenia in the Kashmir region, followed by hematologic malignancies and immune-mediated conditions. Bone marrow examination remains essential for distinguishing between central and peripheral causes and guiding appropriate management.