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Revision as of 15:03, 12 March 2015

Pancytopenia is not equivalent with bone marrow suppression. Pancytopenia is a lab finding that may related to either bone marrow suppression or peripheral sequestration/destruction. For details about bone marrow suppression click here.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2] Ogheneochuko Ajari, MB.BS, MS [3]

Overview

Pancytopenia is the reduction in numbers of all three bone marrow cell types (RBCs + WBCs + platelets). It is not a disease, but rather a lab finding that may related to bone marrow suppression caused by either insufficient production (aplastic anemia), inability of cells or mature (myelodysplasia), or replacement of normal bone marrow with fibrosis (myelofibrosis) or peripheral sequestration/destruction that is not related to the bone marrow (e.g. splenomegaly or hypersplenism). HIV (human immunodeficiency virus) is itself a cause of pancytopenia. Chemotherapy is associated with pancytopenia. Pancytopenia usually requires a bone marrow biopsy in order to distinguish among different causes.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular	No underlying causes
Chemical/Poisoning	Arsenic poisoning, arsenicals, benzene solvents, genotoxic therapy, glue vapors, gold, mutagen exposure, mutagen-detoxification (GSTq1-null), radium chloride, toxins, valproic acid poisoning
Dental	No underlying causes
Dermatologic	Chediak-Higashi disease, dyskeratosis congenita, eosinophilic fasciitis, melanoma, reticular dysgenesis, reticulosis, systemic lupus erythematosus, xeroderma pigmentosum
Drug Side Effect	Acetaminophen and Oxycodone, aclarubicin, albendazole, alemtuzumab, alkylating antineoplastic agent, auranofin, azathioprine, aztreonam, boceprevir, busulfan, carbamazepine, carboplatin, cefadroxil, ceftazidime, certolizumab pegol, chemotherapy, chloramphenicol, chlorpromazine, chlorpropamide, cidofovir, clomipramine, cyclophosphamide, cytotoxic drugs, dactinomycin, docetaxel, doxorubicin, ethosuximide, febuxostat, flucytosine, gemcitabine, gemifloxacin mesylate, genotoxic therapy, idarubicin, indomethacin , infliximab, interferon beta-1a, lincomycin hydrochloride, minocycline hydrochloride, non steroidal anti-inflammatory drugs, ofatumumab, omacetaxine, oxaprozin, oxcarbazepine, penicillamine, phenacemide , phenylbutazone, piperacillin, pralatrexate, propylthiouracil, pyrimethamine, rabeprazole, sulfonamides , tamoxifen, temozolomide, thiothixene, tolazamide, tolbutamide, topoisomerase II interactive agents, trifluoperazine, trimethadione, trimethoprim-sulfamethoxazole, valganciclovir hydrochloride
Ear Nose Throat	Dubowitz syndrome
Endocrine	Osteoporosis, panhypopituitarism, thyroid carcinoma
Environmental	No underlying causes
Gastroenterologic	Banti's syndrome, cirrhosis, Gaucher's disease, hepatosplenic T-cell lymphoma, hypersplenism, intrinsic factor deficiency, malabsorption syndrome, Plummer-Vinson syndrome, portal hypertension, sarcoidosis, Schwachman-Diamond syndrome, splenomegaly
Genetic	Albers-Schonberg disease, ataxia telangiectasia, Banti's syndrome, Bloom syndrome , cartilage-hair hypoplasia, Chediak-Higashi disease, Diamond-Blackfan anemia, DNA repair-deficiency disorder, Down syndrome, Dubowitz syndrome, dyskeratosis congenita, familial histiocytic reticulosis, familial monosomy 7, Fanconi anemia, Gaucher's disease, hemophagocytic lymphohistiocytosis, Hoyeraal-Hreidarsson syndrome, intrinsic factor deficiency, neurofibromatosis 1, Niemann-Pick disease, osteopetrosis lethal, osteopetrosis, autosomal recessive 2, Pearson syndrome, Schwachman-Diamond syndrome, severe combined immunodeficiency, TAR syndrome, trisomy 8 mosaicism, Wiskott-Aldrich syndrome, xeroderma pigmentosum
Hematologic	Acute lymphoblastic leukemia, acute myeloid leukemia, aggressive NK-cell leukemia, amegakaryocytic thrombocytopenia, aplastic anemia, autoimmune lymphoproliferative syndrome type 1, autoimmune lymphoproliferative syndrome type 2, bleeding (Excessive), bone marrow tumor, Castleman's disease, chronic lymphocytic leukaemia, chronic myeloid leukaemia, cyclical neutropenia, Diamond-Blackfan anemia, familial histiocytic reticulosis, familial myelofibrosis, Fanconi anemia, Gaucher's disease, hairy cell leukemia, hematopoietic stem cell transplantation, hemoglobin E disease, hemoglobin H disease, hemoglobin SC disease, hemophagocytic lymphohistiocytosis , hepatosplenic T-cell lymphoma, histiocytosis X, Hodgkin's lymphoma, hypersplenism, hypoplastic myelodysplastic syndromes, ineffective erythropoiesis, intestinal lymphangiectasia, intrinsic factor deficiency, iron deficiency, langerhans cell histiocytosis, leucoerythroblastic anemia, leukemia, lymphoma, malignant histiocytosis, megaloblastic anemia, myelodysplastic syndrome, myelofibrosis, myeloma, myelopathic anemia, non-Hodgkin lymphoma, paroxysmal nocturnal hemoglobinuria, Pearson syndrome, pernicious anemia, Plummer-Vinson syndrome, precursor B acute lymphoblastic leukemia, reticulosis, Schwachman-Diamond syndrome, sickle cell disease, TAR syndrome, t-cell large granular lymphocytic leukemia, Wiskott-Aldrich syndrome
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

3

Causes by Pathophysiology

Bone Marrow Failure

Insufficient production (aplastic anemia)
Inability of cells or mature (myelodysplasia)
Replacement of normal bone marrow with fibrosis (myelofibrosis)

Peripheral Sequestration/Destruction

Causes by Mode of Inheritance

Congenital

Acquired

References

↑ ^1.0 ^1.1 Das Makheja K, Kumar Maheshwari B, Arain S, Kumar S, Kumari S (2013). "The common causes leading to pancytopenia in patients presenting to tertiary care hospital". Pak J Med Sci. 29 (5): 1108–11. PMC 3858928. PMID 24353701.

Template:WikiDoc Sources

[pmid24353701-1] 1.0 ^1.1 Das Makheja K, Kumar Maheshwari B, Arain S, Kumar S, Kumari S (2013). "The common causes leading to pancytopenia in patients presenting to tertiary care hospital". Pak J Med Sci. 29 (5): 1108–11. PMC 3858928. PMID 24353701.

[1]

@@ Line 46: / Line 46: @@
 |-bgcolor="LightSteelBlue"
 | '''Ear Nose Throat'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"|[[Dubowitz syndrome]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Endocrine'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"|[[Osteoporosis]], [[panhypopituitarism]], [[thyroid carcinoma]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 58: / Line 58: @@
 |-bgcolor="LightSteelBlue"
 | '''Gastroenterologic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"|[[Banti's syndrome]], [[cirrhosis]], [[Gaucher's disease]], [[hepatosplenic T-cell lymphoma]], [[hypersplenism]], [[intrinsic factor|intrinsic factor deficiency]], [[malabsorption syndrome]], [[Plummer-Vinson syndrome]], [[portal hypertension]], [[sarcoidosis]], [[Schwachman-Diamond syndrome]], [[splenomegaly]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Genetic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"|[[Albers-Schonberg disease]], [[ataxia telangiectasia]], [[Banti's syndrome]], [[Bloom syndrome ]], [[cartilage-hair hypoplasia]], [[Chediak-Higashi disease]], [[Diamond-Blackfan anemia]], [[DNA repair-deficiency disorder]], [[Down syndrome]], [[Dubowitz syndrome]], [[dyskeratosis congenita]], [[familial histiocytic reticulosis]], [[monosomy|familial monosomy 7]], [[Fanconi anemia]], [[Gaucher's disease]], [[hemophagocytic lymphohistiocytosis]], [[dyskerin|Hoyeraal-Hreidarsson syndrome]], [[intrinsic factor|intrinsic factor deficiency]], [[neurofibromatosis 1]], [[Niemann-Pick disease]], [[osteopetrosis|osteopetrosis lethal]], [[osteopetrosis|osteopetrosis, autosomal recessive 2]], [[Pearson syndrome]], [[Schwachman-Diamond syndrome]], [[severe combined immunodeficiency]], [[TAR syndrome]], [[trisomy 8 mosaicism]], [[Wiskott-Aldrich syndrome]], [[xeroderma pigmentosum]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Hematologic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"|[[Acute lymphoblastic leukemia]], [[acute myeloid leukemia]], [[aggressive NK-cell leukemia]], [[amegakaryocytic thrombocytopenia]], [[aplastic anemia]], [[autoimmune lymphoproliferative syndrome type 1]], [[autoimmune lymphoproliferative syndrome type 2]], [[bleeding (Excessive)]], [[bone marrow disorders|bone marrow tumor]], [[Castleman's disease]], [[chronic lymphocytic leukaemia]], [[chronic myeloid leukaemia]], [[cyclical neutropenia]], [[Diamond-Blackfan anemia]], [[familial histiocytic reticulosis]], [[myelofibrosis|familial myelofibrosis]], [[Fanconi anemia]], [[Gaucher's disease]], [[hairy cell leukemia]], [[hematopoietic stem cell transplantation]], [[hemoglobin E disease]], [[hemoglobin H disease]], [[hemoglobin SC disease]], [[hemophagocytic lymphohistiocytosis ]], [[hepatosplenic T-cell lymphoma]], [[histiocytosis X]], [[Hodgkin's lymphoma]], [[hypersplenism]], [[myelodysplastic syndrome|hypoplastic myelodysplastic syndromes]], [[erythropoiesis|ineffective erythropoiesis]], [[lymphangiectasia|intestinal lymphangiectasia]], [[intrinsic factor|intrinsic factor deficiency]], [[iron deficiency]], [[langerhans cell histiocytosis]], [[leucoerythroblastic|leucoerythroblastic anemia]], [[leukemia]], [[lymphoma]], [[malignant histiocytosis]], [[megaloblastic anemia]], [[myelodysplastic syndrome]], [[myelofibrosis]], [[myeloma]], [[myelophthisis|myelopathic anemia]], [[non-Hodgkin lymphoma]], [[paroxysmal nocturnal hemoglobinuria]], [[Pearson syndrome]], [[pernicious anemia]], [[Plummer-Vinson syndrome]], [[acute lymphoblastic leukemia|precursor B acute lymphoblastic leukemia]], [[reticulosis]], [[Schwachman-Diamond syndrome]], [[sickle cell disease]], [[TAR syndrome]], [[t-cell large granular lymphocytic leukemia]], [[Wiskott-Aldrich syndrome]]
 |-
 |-bgcolor="LightSteelBlue"