Pancytopenia resident survival guide: Difference between revisions

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== Quick-take ==
Urgent hematology consult. Send out labs as detailed below. Plan for pt to get bone marrow biopsy.
== Visual summary ==
== Visual summary ==


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== Differential ==
== Differential ==
'''Hypercellular bone marrow:'''  
'''Hypercellular bone marrow (1/Y):'''
* Common: MDS (1/X)
 
* Rare: PNH, aleukemic leukemia, severe megaloblastic anemia
Common: MDS (3-4/100K)
'''Hypocellular bone marrow:'''
 
* Common: MDS (1/X)
Rare: PNH, aleukemic leukemia, severe megaloblastic anemia
* Rare: PNH, aleukemic leukemia, sever megaloblastic anemia
 
'''Hypocellular bone marrow (1/X):'''


Aplastic anemia (BM stem cell failure): idiopathic (most common), viruses (ParvoB19, HIV, EBV, HHV6), meds (chloramphenicol, NSAIDs, sulfa), other infection (anaplasma)
== Workup ==
== Workup ==
Bone marrow biopsy required for definitive diagnosis.


== Treatment ==
== Treatment ==
Once identified, treat underlying cause.
Once identified, treat underlying cause.
Aplastic anemia:
== Example A/P ==

Revision as of 02:30, 28 May 2016

Quick-take

Urgent hematology consult. Send out labs as detailed below. Plan for pt to get bone marrow biopsy.

Visual summary

Differential

Hypercellular bone marrow (1/Y):

Common: MDS (3-4/100K).

Rare: PNH, aleukemic leukemia, severe megaloblastic anemia

Hypocellular bone marrow (1/X):

Aplastic anemia (BM stem cell failure): idiopathic (most common), viruses (ParvoB19, HIV, EBV, HHV6), meds (chloramphenicol, NSAIDs, sulfa), other infection (anaplasma)

Workup

Bone marrow biopsy required for definitive diagnosis.

Treatment

Once identified, treat underlying cause.

Aplastic anemia:

Example A/P