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|-
|-
! rowspan="10" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hematologic disorders
! 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;" |  
| align="left" style="background:#F5F5F5;" |  
* [[Bone marrow]] infiltration
* [[Bone marrow]] infiltration
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*Might transformed to [[acute leukemia]]
*Might transformed to [[acute leukemia]]
|-
|-
! align="left" style="background:#DCDCDC;" |Malignancies such as:
! align="left" style="background:#DCDCDC;" |Malignancies such as:<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><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>
* [[Acute leukemia]]
* [[Acute leukemia]]
* [[Chronic leukemia]]
* [[Chronic leukemia]]
Line 141: Line 141:
*[[Disseminated intravascular coagulation|DIC]]
*[[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;" + |
| align="left" style="background:#F5F5F5;" + |
* Bone marrow infiltration
* Bone marrow infiltration
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
|-
|-
! align="center" style="background:#DCDCDC;" |[[Aplastic anemia]]<ref name="TownsleyDesmond20132">{{cite journal|last1=Townsley|first1=Danielle M.|last2=Desmond|first2=Ronan|last3=Dunbar|first3=Cynthia E.|last4=Young|first4=Neal S.|title=Pathophysiology and management of thrombocytopenia in bone marrow failure: possible clinical applications of TPO receptor agonists in aplastic anemia and myelodysplastic syndromes|journal=International Journal of Hematology|volume=98|issue=1|year=2013|pages=48–55|issn=0925-5710|doi=10.1007/s12185-013-1352-6}}</ref>
! align="center" style="background:#DCDCDC;" |[[Aplastic anemia]]
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
*Unknown
*Unknown
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*[[Preleukemia]]
*[[Preleukemia]]
|-
|-
! align="center" style="background:#DCDCDC;" |[[Paroxysmal nocturnal hemoglobinuria]]<ref name="pmid25237200">{{cite journal| author=Brodsky RA| title=Paroxysmal nocturnal hemoglobinuria. | journal=Blood | year= 2014 | volume= 124 | issue= 18 | pages= 2804-11 | pmid=25237200 | doi=10.1182/blood-2014-02-522128 | pmc=4215311 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25237200  }}</ref>
! align="center" style="background:#DCDCDC;" |[[Paroxysmal nocturnal hemoglobinuria]]
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
*Deficiency of [[complement]] regulatory proteins
*Deficiency of [[complement]] regulatory proteins

Revision as of 20:16, 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
Lab Findings
Appearance Fever Bleeding BP Splenomegaly Jaundice Other CBC PBS Bone marrow exam PT PTT UA
Bone marrow infiltration Bone marrow failure Destruction/

sequestration/ redistribution

Plt HB WBC
Hematologic disorders Myelodysplastic syndrome[1] + + − ± + Elderly Exposure to + + Nl + + ↓ ↓ ↓ Nl Nl Nl Bone marrow examination + clinical manifestation
Malignancies such as:[2][3] + + + ± ± Any, more in adults
  • Exposure to chemicals
  • Radiation
  • Pre-existent blood disorders
 + + Nl + − ↓ ↓ ↓
  • Blast cells
 ↑ ↑ Bone marrow examination
Myelofibrosis
  • Bone marrow infiltration
 + + − + + Average 60 years old
  • Exposure to chemicals
  • Radiation
  • Pre-existent blood disorders
 + + Nl + - ↓ ↓ ↓ ↑ ↑ Bone marrow examination
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 Gold standard Associated findings
Aplastic anemia
  • Unknown
 − + − ± ± Biphasic (the young and the elderly) − + Nl − − ↓ ↓ ↓ ↑ ↑ Nl Bone marrow examination +

laboratory findings

Paroxysmal nocturnal hemoglobinuria
  • Mutations
 + + − − + Any age

(usually younger adults)

  • Normal
 − − Nl − − ↓/Nl ↓ ↓/Nl
  • Hypocellular marrow in certain stages of the disease
 Nl Nl Flow cytometry
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 Gold standard Associated findings
SLE
Felty syndrome
Wiskott Aldrich syndrome +
GATA2 deficiency +
Hemophagocytic lymphohistiocytosis +
GI disorders Portal hypertension/cirrhosis
  • Splenomegally
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 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:
  • 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 Gold standard Associated findings
  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.
  2. ↑ 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.
  3. ↑ 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.
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