Pancytopenia: Difference between revisions

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*[[Azathioprine]]
*[[Azathioprine]]
*[[Aztreonam]]  
*[[Aztreonam]]  
*[[Babesiosis]]
*[[Babesiosis]] <ref name="pmid23432953">{{cite journal| author=Poisnel E, Ebbo M, Berda-Haddad Y, Faucher B, Bernit E, Carcy B et al.| title=Babesia microti: an unusual travel-related disease. | journal=BMC Infect Dis | year= 2013 | volume= 13 | issue=  | pages= 99 | pmid=23432953 | doi=10.1186/1471-2334-13-99 | pmc=PMC3598249 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23432953  }} </ref>
*[[Banti's syndrome]]
*[[Banti's syndrome]]
*[[benzene|Benzene solvents]]
*[[benzene|Benzene solvents]]
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*[[Malignant histiocytosis]]
*[[Malignant histiocytosis]]
*[[Marasmus]]
*[[Marasmus]]
*[[Megaloblastic anemia]]
*[[Megaloblastic anemia]] <ref name="pmid24669609">{{cite journal| author=Khattak MB, Ismail M, Marwat ZI, Khan F| title=Frequency and characterisation of pancytopenia in megaloblastic anaemia. | journal=J Ayub Med Coll Abbottabad | year= 2012 | volume= 24 | issue= 3-4 | pages= 53-5 | pmid=24669609 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24669609  }} </ref>
*[[Melanoma]]
*[[Melanoma]]
*[[Metastatic neoplasm]]  
*[[Metastatic neoplasm]]  
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*[[Pearson syndrome]]
*[[Pearson syndrome]]
*[[Penicillamine]]
*[[Penicillamine]]
*[[Pernicious anemia]]
*[[Pernicious anemia]] <ref name="pmid23400269">{{cite journal| author=Song IC, Lee HJ, Kim HJ, Bae SB, Lee KT, Yang YJ et al.| title=A multicenter retrospective analysis of the clinical features of pernicious anemia in a Korean population. | journal=J Korean Med Sci | year= 2013 | volume= 28 | issue= 2 | pages= 200-4 | pmid=23400269 | doi=10.3346/jkms.2013.28.2.200 | pmc=PMC3565130 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23400269  }} </ref>
*[[Phenacemide ]]
*[[Phenacemide ]]
*[[Phenylbutazone]]  
*[[Phenylbutazone]]  
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*[[Tuberculosis]]  
*[[Tuberculosis]]  
*[[Valganciclovir hydrochloride]]
*[[Valganciclovir hydrochloride]]
*[[valproic acid|Valproic acid poisoning]]
*[[valproic acid|Valproic acid poisoning]] <ref name="pmid22010461">{{cite journal| author=Klimaszyk D, Łukasik-Głebocka M| title=[Pancytopenia in the course of acute valproic acid poisoning--case report]. | journal=Przegl Lek | year= 2011 | volume= 68 | issue= 8 | pages= 539-42 | pmid=22010461 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22010461  }} </ref><ref name="pmid22797722">{{cite journal| author=Eom TH, Lee HS, Jang PS, Kim YH| title=Valproate-induced panhypogammaglobulinemia. | journal=Neurol Sci | year= 2013 | volume= 34 | issue= 6 | pages= 1003-4 | pmid=22797722 | doi=10.1007/s10072-012-1153-3 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22797722  }} </ref>
*[[Viral infections]]
*[[Viral infections]]
*[[Vitamin B12 deficiency]]
*[[Vitamin B12 deficiency]]

Revision as of 16:17, 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.

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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 Radiation therapy, radioactive p32
Infectious Disease Babesiosis, brucellosis, dengue, Epstein-Barr virus , hepatitis, human immunodeficiency virus , infectious mononucleosis, kala-azar, Kikuchi disease, lassa fever, legionella pneumophila, mycobacterium tuberculosis, parvovirus B19 infection, Q fever, tuberculosis, viral infections, Whipple's disease
Musculoskeletal/Orthopedic Albers-Schonberg disease, ankylosing spondylitis, cartilage-hair hypoplasia, Ewing's sarcoma, osteoclastoma, osteopetrosis lethal, osteopetrosis, autosomal recessive 2, osteoporosis, osteosarcoma, TAR syndrome
Neurologic Ataxia telangiectasia, Down syndrome , neuroblastoma, neurofibromatosis 1, Niemann-Pick disease
Nutritional/Metabolic Anorexia nervosa, copper deficiency, folate deficiency, Gaucher's disease, glutathione synthase deficiency, iron deficiency, kwashiorkor, marasmus, obesity, vitamin B12 deficiency, vitamin C deficiency
Obstetric/Gynecologic Pregnancy
Oncologic Acute lymphoblastic leukemia, acute myeloid leukemia, aggressive NK-cell leukemia, bone marrow tumor, cancer, chondrosarcoma, chronic lymphocytic leukaemia, chronic myeloid leukaemia, epiphyseal tumors, Ewing's sarcoma, familial myelofibrosis, germ cell tumors , granuloma, hairy cell leukemia, hepatosplenic T-cell lymphoma, histiocytosis X, Hodgkin's lymphoma, hypoplastic myelodysplastic syndromes, langerhans cell histiocytosis, leukemia, lymphoma, melanoma, metastatic neoplasm, myelodysplastic syndrome, myelofibrosis, myeloma, neuroblastoma, non-Hodgkin lymphoma, osteoclastoma, osteosarcoma, precursor B acute lymphoblastic leukemia, prostate cancer, t-cell large granular lymphocytic leukemia, thymoma, thyroid carcinoma
Ophthalmologic No underlying causes
Overdose/Toxicity Colchicine toxicity
Psychiatric Anorexia nervosa
Pulmonary Sarcoidosis
Renal/Electrolyte Renal failure, chronic, systemic lupus erythematosus
Rheumatology/Immunology/Allergy Ankylosing spondylitis, auto-immune disorders, autoimmune lymphoproliferative syndrome type 1, autoimmune lymphoproliferative syndrome type 2, Castleman's disease, common variable hypogammaglobulinemia, common variable immune deficiency, eosinophilic fasciitis , Felty's syndrome, graft versus host disease, histiocytosis X, langerhans cell histiocytosis, rheumatoid disease, sarcoidosis, severe combined immunodeficiency, systemic lupus erythematosus, Wiskott-Aldrich syndrome
Sexual No underlying causes
Trauma No underlying causes
Urologic Prostate cancer
Miscellaneous Idiopathic, radioactive p32, tobacco use

Causes in Alphabetical Order

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3

Causes by Pathophysiology

Bone Marrow Failure

Peripheral Sequestration/Destruction

Causes by Mode of Inheritance

Congenital

Acquired

References

  1. ↑ 1.0 1.1 1.2 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.
  2. ↑ Poisnel E, Ebbo M, Berda-Haddad Y, Faucher B, Bernit E, Carcy B; et al. (2013). "Babesia microti: an unusual travel-related disease". BMC Infect Dis. 13: 99. doi:10.1186/1471-2334-13-99. PMC 3598249. PMID 23432953.
  3. ↑ Guler S, Kokoglu OF, Ucmak H, Gul M, Ozden S, Ozkan F (2014). "Human brucellosis in Turkey: different clinical presentations". J Infect Dev Ctries. 8 (5): 581–8. doi:10.3855/jidc.3510. PMID 24820461.
  4. ↑ Bajaj P, Clement J, Bayerl MG, Kalra N, Craig TJ, Ishmael FT (2014). "High-grade fever and pancytopenia in an adult patient with common variable immune deficiency". Allergy Asthma Proc. 35 (1): 78–82. doi:10.2500/aap.2014.35.3704. PMID 24433602.
  5. ↑ Zhang X, Wang Z, Wang L, Yao H (2013). "An adult case of systemic Epstein-Barr virus-positive T/natural killer-cell lymphoproliferative disorder with good outcome". Int J Clin Exp Pathol. 6 (11): 2620–4. PMC 3816837. PMID 24228130.
  6. ↑ Suyama T, Obara N, Kawai K, Yamada K, Kusakabe M, Kurita N; et al. (2013). "[Acute myeloid leukemia possibly originating from the same clone of testicular germ cell tumor]". Rinsho Ketsueki. 54 (8): 764–8. PMID 24005437.
  7. ↑ Jain A, Naniwadekar M (2013). "An etiological reappraisal of pancytopenia - largest series reported to date from a single tertiary care teaching hospital". BMC Hematol. 13 (1): 10. doi:10.1186/2052-1839-13-10. PMC 4177001. PMID 24238033.
  8. ↑ Khattak MB, Ismail M, Marwat ZI, Khan F (2012). "Frequency and characterisation of pancytopenia in megaloblastic anaemia". J Ayub Med Coll Abbottabad. 24 (3–4): 53–5. PMID 24669609.
  9. ↑ Germing U, Kobbe G, Haas R, Gattermann N (2013). "Myelodysplastic syndromes: diagnosis, prognosis, and treatment". Dtsch Arztebl Int. 110 (46): 783–90. doi:10.3238/arztebl.2013.0783. PMC 3855821. PMID 24300826.
  10. ↑ Rajput R, Sehgal A, Jain D, Sen R, Gupta A (2012). "Acute parvovirus b19 infection leading to severe aplastic anemia in a previously healthy adult female". Indian J Hematol Blood Transfus. 28 (2): 123–6. doi:10.1007/s12288-011-0112-0. PMC 3332267. PMID 23730023.
  11. ↑ Song IC, Lee HJ, Kim HJ, Bae SB, Lee KT, Yang YJ; et al. (2013). "A multicenter retrospective analysis of the clinical features of pernicious anemia in a Korean population". J Korean Med Sci. 28 (2): 200–4. doi:10.3346/jkms.2013.28.2.200. PMC 3565130. PMID 23400269.
  12. ↑ Klimaszyk D, Łukasik-Głebocka M (2011). "[Pancytopenia in the course of acute valproic acid poisoning--case report]". Przegl Lek. 68 (8): 539–42. PMID 22010461.
  13. ↑ Eom TH, Lee HS, Jang PS, Kim YH (2013). "Valproate-induced panhypogammaglobulinemia". Neurol Sci. 34 (6): 1003–4. doi:10.1007/s10072-012-1153-3. PMID 22797722.
  14. ↑ Tun NT, Shukla S, Krishnakurup J, Pappachen B, Krishnamurthy M, Salib H (2014). "An unusual cause of pancytopenia: Whipple's disease". J Community Hosp Intern Med Perspect. 4. doi:10.3402/jchimp.v4.23482. PMC 3992356. PMID 24765256.


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