Sandbox: sadaf: Difference between revisions

Revision as of 19:18, 10 September 2018

Differentiating Pancytopenia from Other Diseases

There are no other mimickers of pancytopenia, as the diagnosis can be unequivocally established by laboratory testing (complete blood count).

Category	Condition	Etiology	Mechanism			Congenital	Acquried	Clinical manifestations									Para−clinical findings									Gold standard	Associated findings
								Demography	History	Symptoms			Signs				Para−clinical findings
										Symptoms			Signs				Lab Findings								Imaging
										Appearance	Fever	Bleeding	BP	Splenomegaly	Jaundice	Other	CBC			PBS	Bone marrow exam	PT	PTT	UA
			Bone marrow infiltration	Bone marrow failure	Destruction/ sequestration/ redistribution					Appearance	Fever	Bleeding	BP	Splenomegaly	Jaundice	Other	Plt	HB	WBC	PBS	Bone marrow exam	PT	PTT	UA
Hematologic disorders	Myelodysplastic syndrome^[1]	Bone marrow infiltration Ineffective hematopoiesis	+	+	-	±	+	Elderly	Exposure to Chemotherapy Radiation therapy Tobacco smoke	Petechiae Purpura Diffuse erythematous rash	+	+	Nl	+	+	Shortness of breath Fatigue Pallor	↓	↓	↓	Ovalomacrocytosis Basophilic stippling Howell-Jolly body Dysplastic neutrophils	Impaired myeloid maturation Dyserythropoiesis Dysgranulopoiesis Dysmegakaryocytopoiesis Hypercellular bone marrow Fibrosis	Nl	Nl	Nl	NA	Bone marrow examination + clinical manifestation	Might transformed to acute leukemia
	Malignancies such as:^[2]^[3] Acute leukemia Chronic leukemia Multiple myeloma Metastatic cancer	Bone marrow infiltration Ineffective hematopoiesis Immune mediated	+	+	+	±	±	Any, more in adults	Exposure to chemicals Radiation Pre-existent blood disorders	Petechiae	+	+	Nl	+	-	Weakness	↓	↓	↓	Pancytopenia	Blast cells	↑	↑	Hemoglobinuria	NA	Bone marrow examination	Tumor lysis syndrome Infection CNS involvement DIC
	Myelofibrosis	Bone marrow infiltration	+	+	-	+	+	Average 60 years old		Pallor Major weight loss	+	+	Nl	+	-	Weakness Fatigue Shortness of breath Headache	↓	↓	↓	Pancytopenia	Pancytopenia Hypercellular bone marrow Fibrosis	↑	↑	Hemoglobinuria	NA	Bone marrow examination	Arrhythmia Infection Seizure May progress to malignancy
	Fanconi anemia
	Condition	Etiology	Bone marrow infiltration	Bone marrow failure	Destruction/ sequestration/ redistribution	Congenital	Acquried	Demography	History	Appearance	Fever	Bleeding	BP	Splenomegaly	Jaundice	Other signs	Plt	HB	WBC	PBS	Bone marrow exam	PT	PTT	UA	Imaging	Gold standard	Associated findings
	Aplastic anemia	Immune destruction		+
	Paroxysmal nocturnal hemoglobinuria	Immune destruction		+
	Disseminated intravascular coagulation	Consumption
	Dyskeratosis congenital/telomere biology disorders
	Shwachman-Diamond syndrome					+
Immunology/ Rheumatology	Condition	Etiology	Bone marrow infiltration	Bone marrow failure	Destruction/ sequestration/ redistribution	Congenital	Acquried	Demography	History	Appearance	Fever	Bleeding	BP	Splenomegaly	Jaundice	Other signs	Plt	HB	WBC	PBS	Bone marrow exam	PT	PTT	UA	Imaging	Gold standard	Associated findings
	SLE
	Felty syndrome
	Wiskott Aldrich syndrome					+
	GATA2 deficiency					+
	Hemophagocytic lymphohistiocytosis					+
GI disorders	Portal hypertension/cirrhosis	Splenomegally
GI disorders	Storage diseases (eg, Gaucher)	Splenomegaly Bone marrow infiltration	+		+
Infections	Condition	Etiology	Bone marrow infiltration	Bone marrow failure	Destruction/ sequestration/ redistribution	Congenital	Acquried	Demography	History	Appearance	Fever	Bleeding	BP	Splenomegaly	Jaundice	Other signs	Plt	HB	WBC	PBS	Bone marrow exam	PT	PTT	UA	Imaging	Gold standard	Associated findings
	Sepsis	Bone marrow infiltration
	Viral infection such as HIV, hepatitis, Epstein-Barr virus	Marrow suppression Splenomegaly		+	+
Nutritional	Megaloblastic anemia	Ineffective hematopoiesis		+
	Excessive alcohol	Ineffective hematopoiesis
	Other nutritional deficiency such as copper deficiency, zinc toxicity	Ineffective hematopoiesis
	Malnutrition	Ineffective hematopoiesis
Medications	Medications such as: Cytotoxic drugs Idiosyncratic reactions to medications	Immune destruction		+
Category	Condition	Etiology	Bone marrow infiltration	Bone marrow failure	Destruction/ sequestration/ redistribution	Congenital	Acquried	Demography	History	Appearance	Fever	Bleeding	BP	Splenomegaly	Jaundice	Other signs	Plt	HB	WBC	PBS	Bone marrow exam	PT	PTT	UA	Imaging	Gold standard	Associated findings

↑ Natelson, Ethan A.; Pyatt, David (2013). "Acquired Myelodysplasia or Myelodysplastic Syndrome: Clearing the Fog". Advances in Hematology. 2013: 1–11. doi:10.1155/2013/309637. ISSN 1687-9104.
↑ Oshima Y, Yuji K, Tanimoto T, Hinomura Y, Tojo A (2013). "Association between acute myelogenous leukemia and thrombopoietin receptor agonists in patients with immune thrombocytopenia". Intern. Med. 52 (19): 2193–201. PMID 24088751.
↑ Oshima, Yasuo; Yuji, Koichiro; Tanimoto, Tetsuya; Hinomura, Yasushi; Tojo, Arinobu (2013). "Association between Acute Myelogenous Leukemia and Thrombopoietin Receptor Agonists in Patients with Immune Thrombocytopenia". Internal Medicine. 52 (19): 2193–2201. doi:10.2169/internalmedicine.52.0324. ISSN 0918-2918.

[NatelsonPyatt2013-1] Natelson, Ethan A.; Pyatt, David (2013). "Acquired Myelodysplasia or Myelodysplastic Syndrome: Clearing the Fog". Advances in Hematology. 2013: 1–11. doi:10.1155/2013/309637. ISSN 1687-9104.

[pmid24088751-2] Oshima Y, Yuji K, Tanimoto T, Hinomura Y, Tojo A (2013). "Association between acute myelogenous leukemia and thrombopoietin receptor agonists in patients with immune thrombocytopenia". Intern. Med. 52 (19): 2193–201. PMID 24088751.

[OshimaYuji2013-3] Oshima, Yasuo; Yuji, Koichiro; Tanimoto, Tetsuya; Hinomura, Yasushi; Tojo, Arinobu (2013). "Association between Acute Myelogenous Leukemia and Thrombopoietin Receptor Agonists in Patients with Immune Thrombocytopenia". Internal Medicine. 52 (19): 2193–2201. doi:10.2169/internalmedicine.52.0324. ISSN 0918-2918.

[1]

[2]

[3]

@@ Line 46: / Line 46: @@
 |-
 ! rowspan="10" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hematologic disorders
-! align="center" style="background:#DCDCDC;" |[[Myelodysplastic syndrome (patient information)|Myelodysplastic syndrome]]
+! align="center" style="background:#DCDCDC;" |[[Myelodysplastic syndrome (patient information)|Myelodysplastic syndrome]]<ref name="NatelsonPyatt2013">{{cite journal|last1=Natelson|first1=Ethan A.|last2=Pyatt|first2=David|title=Acquired Myelodysplasia or Myelodysplastic Syndrome: Clearing the Fog|journal=Advances in Hematology|volume=2013|year=2013|pages=1–11|issn=1687-9104|doi=10.1155/2013/309637}}</ref>
 | align="left" style="background:#F5F5F5;" |
 * [[Bone marrow]] infiltration
@@ Line 96: / Line 96: @@
 *Might transformed to [[acute leukemia]]
 |-
-! align="left" style="background:#DCDCDC;" |Malignancies such as:
+! align="left" style="background:#DCDCDC;" |Malignancies such as:<ref name="pmid24088751">{{cite journal |vauthors=Oshima Y, Yuji K, Tanimoto T, Hinomura Y, Tojo A |title=Association between acute myelogenous leukemia and thrombopoietin receptor agonists in patients with immune thrombocytopenia |journal=Intern. Med. |volume=52 |issue=19 |pages=2193–201 |date=2013 |pmid=24088751 |doi= |url=}}</ref><ref name="OshimaYuji2013">{{cite journal|last1=Oshima|first1=Yasuo|last2=Yuji|first2=Koichiro|last3=Tanimoto|first3=Tetsuya|last4=Hinomura|first4=Yasushi|last5=Tojo|first5=Arinobu|title=Association between Acute Myelogenous Leukemia and Thrombopoietin Receptor Agonists in Patients with Immune Thrombocytopenia|journal=Internal Medicine|volume=52|issue=19|year=2013|pages=2193–2201|issn=0918-2918|doi=10.2169/internalmedicine.52.0324}}</ref>
 * [[Acute leukemia]]
 * [[Chronic leukemia]]
@@ Line 144: / Line 144: @@
 *[[Disseminated intravascular coagulation|DIC]]
 |-
-! align="center" style="background:#DCDCDC;" |[[Myelofibrosis]]<ref name="BaePark2013">{{cite journal|last1=Bae|first1=E.|last2=Park|first2=C.-J.|last3=Cho|first3=Y.-U.|last4=Seo|first4=E.-J.|last5=Chi|first5=H.-S.|last6=Jang|first6=S.|last7=Lee|first7=K.-H.|last8=Lee|first8=J.-H.|last9=Lee|first9=J.-H.|last10=Suh|first10=J.-J.|last11=Im|first11=H.-J.|title=Differential diagnosis of myelofibrosis based on WHO 2008 criteria: Acute panmyelosis with myelofibrosis, acute megakaryoblastic leukemia with myelofibrosis, primary myelofibrosis and myelodysplastic syndrome with myelofibrosis|journal=International Journal of Laboratory Hematology|volume=35|issue=6|year=2013|pages=629–636|issn=17515521|doi=10.1111/ijlh.12101}}</ref>
+! align="center" style="background:#DCDCDC;" |[[Myelofibrosis]]
 | align="left" style="background:#F5F5F5;" + |
 * Bone marrow infiltration
@@ Line 157: / Line 157: @@
 * [[Pallor]]
 * Major weight loss
-| align="center" style="background:#F5F5F5;" + |+
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |+
+| align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + |Nl
-| align="center" style="background:#F5F5F5;" + |+
+| align="center" style="background:#F5F5F5;" + | +
-| align="center" style="background:#F5F5F5;" + |-
+| align="center" style="background:#F5F5F5;" + | -
 | align="center" style="background:#F5F5F5;" + |
 *[[Muscle weakness|Weakness]]
@@ Line 189: / Line 189: @@
 * May progress to malignancy
 |-
-! align="center" style="background:#DCDCDC;" |Fanconi anemia
+! align="center" style="background:#DCDCDC;" |[[Fanconi anemia]]
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 247: / Line 247: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
 |-
-! align="center" style="background:#DCDCDC;" |Aplastic anemia
+! align="center" style="background:#DCDCDC;" |[[Aplastic anemia]]
 | align="center" style="background:#F5F5F5;" + |
 * Immune destruction
@@ Line 276: / Line 276: @@
 | align="center" style="background:#F5F5F5;" + |
 |-
-! align="center" style="background:#DCDCDC;" |Paroxysmal nocturnal hemoglobinuria
+! align="center" style="background:#DCDCDC;" |[[Paroxysmal nocturnal hemoglobinuria]]
 | align="center" style="background:#F5F5F5;" + |Immune destruction
 | align="center" style="background:#F5F5F5;" + |
@@ Line 304: / Line 304: @@
 | align="center" style="background:#F5F5F5;" + |
 |-
-! align="center" style="background:#DCDCDC;" |Disseminated intravascular coagulation
+! align="center" style="background:#DCDCDC;" |[[Disseminated intravascular coagulation]]
 | align="center" style="background:#F5F5F5;" + |Consumption
 | align="center" style="background:#F5F5F5;" + |
@@ Line 360: / Line 360: @@
 | align="center" style="background:#F5F5F5;" + |
 |-
-! align="center" style="background:#DCDCDC;" |Shwachman-Diamond syndrome
+! align="center" style="background:#DCDCDC;" |[[Shwachman-Diamond syndrome]]
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 420: / Line 420: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
 |-
-! align="center" style="background:#DCDCDC;" |SLE
+! align="center" style="background:#DCDCDC;" |[[SLE]]
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 448: / Line 448: @@
 | align="center" style="background:#F5F5F5;" + |
 |-
-! align="center" style="background:#DCDCDC;" |Felty syndrome
+! align="center" style="background:#DCDCDC;" |[[Felty's syndrome|Felty syndrome]]
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 476: / Line 476: @@
 | align="center" style="background:#F5F5F5;" + |
 |-
-! align="center" style="background:#DCDCDC;" |Wiskott Aldrich syndrome
+! align="center" style="background:#DCDCDC;" |[[Wiskott-Aldrich syndrome|Wiskott Aldrich syndrome]]
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 504: / Line 504: @@
 | align="center" style="background:#F5F5F5;" + |
 |-
-! align="center" style="background:#DCDCDC;" |GATA2 deficiency
+! align="center" style="background:#DCDCDC;" |[[GATA2]] deficiency
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 532: / Line 532: @@
 | align="center" style="background:#F5F5F5;" + |
 |-
-! align="center" style="background:#DCDCDC;" |Hemophagocytic lymphohistiocytosis (HLH)
+! align="center" style="background:#DCDCDC;" |[[Hemophagocytic lymphohistiocytosis]]
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 561: / Line 561: @@
 |-
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |GI disorders
-! align="center" style="background:#DCDCDC;" |Portal hypertension/cirrhosis
+! align="center" style="background:#DCDCDC;" |[[Portal hypertension]]/[[cirrhosis]]
 | align="left" style="background:#F5F5F5;" + |
 * Splenomegally
@@ Line 590: / Line 590: @@
 | align="center" style="background:#F5F5F5;" + |
 |-
-! align="center" style="background:#DCDCDC;" |Storage diseases (eg, Gaucher)
+! align="center" style="background:#DCDCDC;" |[[Glycogen storage disease|Storage diseases]] (eg, [[Gaucher's disease|Gaucher]])
 | align="left" style="background:#F5F5F5;" + |
 * Splenomegaly
@@ Line 651: / Line 651: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
 |-
-! align="center" style="background:#DCDCDC;" |Sepsis
+! align="center" style="background:#DCDCDC;" |[[Sepsis]]
 | align="left" style="background:#F5F5F5;" + |
 * Bone marrow infiltration
@@ Line 680: / Line 680: @@
 | align="center" style="background:#F5F5F5;" + |
 |-
-! align="center" style="background:#DCDCDC;" |Viral infection such as HIV, hepatitis, Epstein-Barr virus
+! align="center" style="background:#DCDCDC;" |[[Infection|Viral infection]] such as [[Human Immunodeficiency Virus (HIV)|HIV]], [[hepatitis]], [[Epstein Barr virus|Epstein-Barr virus]]
 | align="left" style="background:#F5F5F5;" + |
 * Marrow suppression
@@ Line 711: / Line 711: @@
 |-
 ! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nutritional
-! align="center" style="background:#DCDCDC;" |Megaloblastic anemia
+! align="center" style="background:#DCDCDC;" |[[Macrocytic anemia|Megaloblastic anemia]]
 | align="left" style="background:#F5F5F5;" + |
 * Ineffective hematopoiesis
@@ Line 740: / Line 740: @@
 | align="center" style="background:#F5F5F5;" + |
 |-
-! align="center" style="background:#DCDCDC;" |Excessive alcohol
+! align="center" style="background:#DCDCDC;" |Excessive [[alcohol]]
 | align="left" style="background:#F5F5F5;" + |
 * Ineffective hematopoiesis
@@ Line 769: / Line 769: @@
 | align="center" style="background:#F5F5F5;" + |
 |-
-! align="center" style="background:#DCDCDC;" |Other (eg, copper deficiency, zinc toxicity)
+! align="center" style="background:#DCDCDC;" |Other nutritional deficiency such as [[copper deficiency]], [[zinc]] toxicity
 | align="left" style="background:#F5F5F5;" + |
 * Ineffective hematopoiesis
@@ Line 798: / Line 798: @@
 | align="center" style="background:#F5F5F5;" + |
 |-
-! align="center" style="background:#DCDCDC;" |Malnutrition
+! align="center" style="background:#DCDCDC;" |[[Malnutrition]]
 | align="left" style="background:#F5F5F5;" + |
 * Ineffective hematopoiesis
@@ Line 829: / Line 829: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Medications
 ! align="left" style="background:#DCDCDC;" |Medications such as:
-* Cytotoxic drugs
+* [[Chemotherapy|Cytotoxic drugs]]
 * Idiosyncratic reactions to medications
 | align="left" style="background:#F5F5F5;" + |

Sandbox: sadaf: Difference between revisions

Revision as of 19:18, 10 September 2018

Differentiating Pancytopenia from Other Diseases

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