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pancytopenia

Diminished numbers of erythrocytes, leukocytes & platelets in the peripheral blood. Etiology: 1) impaired production a) disorders of precursors - aplastic anemia - sideroblastic anemia [3] - myelodysplastic syndrome - aleukemic leukemia - idiopathic myelofibrosis b) infiltrative disease of the bone marrow - lymphoma - multiple myeloma - other metastatic malignancy - infection, granulomas - osteopetrosis c) exogenous factors - drugs or toxins, including alcohol - vitamin B12 deficiency or folate deficiency - viral infection 2) increased destruction - autoimmune - hemophagocytic syndrome - paroxysmal nocturnal hemoglobinuria (PNH) 3) splenic pooling Laboratory: - complete blood count (CBC) (pancytopenia, decrease in all cellular components) - reticulocyte count low - serum folate &/or serum B12 may be low - serum iron, TIBC & serum ferritin - hepatitis serology - HIV testing - serum protein electrophoresis & urine protein electrophoresis to r/o multiple myeloma - flow cytometry (cytogenetic analysis) Special laboratory: - bone marrow aspirate & bone marrow biopsy Radiology: - ultrasound of abdomen to assess for splenomegaly

Related

aplastic anemia folic acid; folate; vitamin B9 granuloma leukemia lymphoma (lymphosarcoma) multiple myeloma; plasmacytoma/plasma cell myeloma myelodysplastic syndrome (MDS) myelofibrosis paroxysmal nocturnal hemoglobinuria (PNH, Marchiafava-Micheli syndrome) vitamin B12; cobalamin

General

bone marrow hypoplasia/failure (myelosuppression) sign/symptom

References

  1. Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
  2. Medical Knowledge Self Assessment Program (MKSAP) 11, 17. American College of Physicians, Philadelphia 1998, 2015 - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  3. Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
  4. Devitt KA, Lunde JH, Lewis MR. New onset pancytopenia in adults: a review of underlying pathologies and their associated clinical and laboratory findings. Leuk Lymphoma. 2014 May;55(5):1099-105 PMID: 23829306