Sandbox: sadaf: Difference between revisions
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! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nutritional | ! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nutritional | ||
! align="center" style="background:#DCDCDC;" |[[Macrocytic anemia|Megaloblastic anemia]] | ! align="center" style="background:#DCDCDC;" |[[Macrocytic anemia|Megaloblastic anemia]]<ref name="pmid24669609">{{cite journal |vauthors=Khattak MB, Ismail M, Marwat ZI, Khan F |title=Frequency and characterisation of pancytopenia in megaloblastic anaemia |journal=J Ayub Med Coll Abbottabad |volume=24 |issue=3-4 |pages=53–5 |date=2012 |pmid=24669609 |doi= |url=}}</ref> | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Ineffective hematopoiesis | * Ineffective hematopoiesis | ||
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| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + | | ||
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! align="center" style="background:#DCDCDC;" |Excessive [[alcohol]] | ! align="center" style="background:#DCDCDC;" |Excessive [[alcohol]]<ref name="pmid3671238">{{cite journal |vauthors=Weston CF, Hall MJ |title=Pancytopenia and folate deficiency in alcoholics |journal=Postgrad Med J |volume=63 |issue=736 |pages=117–20 |date=February 1987 |pmid=3671238 |pmc=2428237 |doi= |url=}}</ref> | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Ineffective hematopoiesis | * Ineffective hematopoiesis | ||
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! align="center" style="background:#DCDCDC;" |Other nutritional deficiency such as [[copper deficiency]], [[zinc]] toxicity | ! align="center" style="background:#DCDCDC;" |Other nutritional deficiency such as [[copper deficiency]], [[zinc]] toxicity<ref name="pmid23652881">{{cite journal |vauthors=Hudspeth M, Turner A, Miller N, Lazarchick J |title=Pancytopenia after allogeneic bone marrow transplant due to copper deficiency |journal=J. Pediatr. Hematol. Oncol. |volume=36 |issue=4 |pages=316–8 |date=May 2014 |pmid=23652881 |doi=10.1097/MPH.0b013e318290c644 |url=}}</ref><ref name="pmid24082414">{{cite journal |vauthors=Robinson SD, Cooper B, Leday TV |title=Copper deficiency (hypocupremia) and pancytopenia late after gastric bypass surgery |journal=Proc (Bayl Univ Med Cent) |volume=26 |issue=4 |pages=382–6 |date=October 2013 |pmid=24082414 |pmc=3777101 |doi= |url=}}</ref> | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Ineffective hematopoiesis | * Ineffective hematopoiesis | ||
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| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + | | ||
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! align="center" style="background:#DCDCDC;" |[[Malnutrition]] | ! align="center" style="background:#DCDCDC;" |[[Malnutrition]]<ref name="DragusinMurray2015">{{cite journal|last1=Dragusin|first1=Roxana C.|last2=Murray|first2=Jean-Michel|last3=Mallet|first3=Dominique|last4=Gonzalez|first4=Hugo|last5=Markou|first5=Georges A.|title=Pancytopenia related to malnutrition during pregnancy|journal=International Journal of Gynecology & Obstetrics|volume=130|issue=1|year=2015|pages=86–87|issn=00207292|doi=10.1016/j.ijgo.2015.02.020}}</ref> | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Ineffective hematopoiesis | * Ineffective hematopoiesis | ||
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Medications | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Medications | ||
! align="left" style="background:#DCDCDC;" |Medications such as: | ! align="left" style="background:#DCDCDC;" |Medications such as:<ref name="pmid22862866">{{cite journal |vauthors=Kelm DJ, Torres KM, Sohail MR |title=46-year-old man with fevers, chills, and pancytopenia |journal=Mayo Clin. Proc. |volume=87 |issue=8 |pages=799–802 |date=August 2012 |pmid=22862866 |pmc=3498402 |doi=10.1016/j.mayocp.2012.03.012 |url=}}</ref><ref name="pmid24937727">{{cite journal |vauthors=Davis SA, Krowchuk DP, Feldman SR |title=Prescriptions for a toxic combination: use of methotrexate plus trimethoprim-sulfamethoxazole in the United States |journal=South. Med. J. |volume=107 |issue=5 |pages=292–3 |date=May 2014 |pmid=24937727 |doi=10.1097/SMJ.0000000000000098 |url=}}</ref> | ||
* [[Chemotherapy|Cytotoxic drugs]] | * [[Chemotherapy|Cytotoxic drugs]] | ||
* Idiosyncratic reactions to medications | * Idiosyncratic reactions to medications |
Revision as of 20:43, 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 |
|
+ | + | Nl | + | − | ↓ | ↓ | ↓ |
|
↑ | ↑ | Bone marrow examination |
| |||||
Myelofibrosis[4] |
|
+ | + | − | + | + | Average 60 years old |
|
|
+ | + | Nl | + | - | ↓ | ↓ | ↓ |
|
↑ | ↑ | Bone marrow examination |
| ||||
Fanconi anemia[5] | ||||||||||||||||||||||||||
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[6] |
|
− | + | − | ± | ± | Biphasic (the young and the elderly) |
|
− | + | Nl | − | − | ↓ | ↓ | ↓ |
|
|
↑ | ↑ | Nl | Bone marrow examination +
laboratory findings |
||||
Paroxysmal nocturnal hemoglobinuria[7] |
|
+ | + | − | − | + | Any age
(usually younger adults) |
|
|
− | − | Nl | − | − |
|
↓/Nl | ↓ | ↓/Nl |
|
Nl | Nl | Flow cytometry | ||||
Disseminated intravascular coagulation[8] | Consumption | |||||||||||||||||||||||||
Dyskeratosis congenital/telomere biology disorders[9] | ||||||||||||||||||||||||||
Shwachman-Diamond syndrome[10] | + | |||||||||||||||||||||||||
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[11] | ||||||||||||||||||||||||||
Felty syndrome[12] | ||||||||||||||||||||||||||
Wiskott Aldrich syndrome[13] | + | |||||||||||||||||||||||||
GATA2 deficiency[14] | + | |||||||||||||||||||||||||
Hemophagocytic lymphohistiocytosis[15] | + | |||||||||||||||||||||||||
GI disorders | Portal hypertension/cirrhosis[16][17] |
|
||||||||||||||||||||||||
Storage diseases (eg, Gaucher)[18] |
|
+ | + | |||||||||||||||||||||||
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[19] |
|
|||||||||||||||||||||||||
Viral infection such as HIV, hepatitis, Epstein-Barr virus[20] |
|
+ | + | |||||||||||||||||||||||
Nutritional | Megaloblastic anemia[21] |
|
+ | |||||||||||||||||||||||
Excessive alcohol[22] |
|
|||||||||||||||||||||||||
Other nutritional deficiency such as copper deficiency, zinc toxicity[23][24] |
|
|||||||||||||||||||||||||
Malnutrition[25] |
|
|||||||||||||||||||||||||
Medications | Medications such as:[26][27]
|
|
+ | |||||||||||||||||||||||
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 |
- ↑ 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, 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.
- ↑ 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.
- ↑ Bae, E.; Park, C.-J.; Cho, Y.-U.; Seo, E.-J.; Chi, H.-S.; Jang, S.; Lee, K.-H.; Lee, J.-H.; Lee, J.-H.; Suh, J.-J.; Im, H.-J. (2013). "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". International Journal of Laboratory Hematology. 35 (6): 629–636. doi:10.1111/ijlh.12101. ISSN 1751-5521.
- ↑ Zhang, Qing-Shuo; Benedetti, Eric; Deater, Matthew; Schubert, Kathryn; Major, Angela; Pelz, Carl; Impey, Soren; Marquez-Loza, Laura; Rathbun, R. Keaney; Kato, Shigeaki; Bagby, Grover C.; Grompe, Markus (2015). "Oxymetholone Therapy of Fanconi Anemia Suppresses Osteopontin Transcription and Induces Hematopoietic Stem Cell Cycling". Stem Cell Reports. 4 (1): 90–102. doi:10.1016/j.stemcr.2014.10.014. ISSN 2213-6711.
- ↑ Dolberg, Osnat Jarchowsky; Levy, Yair (2014). "Idiopathic aplastic anemia: Diagnosis and classification". Autoimmunity Reviews. 13 (4–5): 569–573. doi:10.1016/j.autrev.2014.01.014. ISSN 1568-9972.
- ↑ Boyer, Thomas; Grardel, Nathalie; Copin, Marie-Christine; Roumier, Christophe; Touzart, Aurore; Buchdahl, Anne-Laure; Corm, Sélim; de Latour, Régis Peffault; Preudhomme, Claude; Terriou, Louis (2015). "Paroxysmal nocturnal hemoglobinuria (PNH) and T cell large granular lymphocyte (LGL) leukemia—an unusual association: another cause of cytopenia in PNH". Annals of Hematology. 94 (10): 1759–1760. doi:10.1007/s00277-015-2439-3. ISSN 0939-5555.
- ↑ Hossain, Nazli; Paidas, Michael J. (2013). "Disseminated intravascular coagulation". Seminars in Perinatology. 37 (4): 257–266. doi:10.1053/j.semperi.2013.04.008. ISSN 0146-0005.
- ↑ Paiva, Raquel M.A.; Calado, Rodrigo T. (2014). "Telomere Dysfunction and Hematologic Disorders". 125: 133–157. doi:10.1016/B978-0-12-397898-1.00006-2. ISSN 1877-1173.
- ↑ Gokce, Muge; Tuncer, Murat; Cetin, Mualla; Gumruk, Fatma (2012). "Molecular Diagnosis of Shwachman-Diamond Syndrome Presenting with Pancytopenia at an Early Age: The First Report from Turkey". Indian Journal of Hematology and Blood Transfusion. 29 (3): 161–163. doi:10.1007/s12288-012-0163-x. ISSN 0971-4502.
- ↑ Newman, Kam; Owlia, Mohammad Bagher; El-Hemaidi, Ihab; Akhtari, Mojtaba (2013). "Management of immune cytopenias in patients with systemic lupus erythematosus — Old and new". Autoimmunity Reviews. 12 (7): 784–791. doi:10.1016/j.autrev.2013.02.001. ISSN 1568-9972.
- ↑ Liatsos, George D.; Tsironi, Ioanna; Vassilopoulos, Dimitrios; Dourakis, Spyridon (2018). "Severe pancytopenia and splenomegaly associated with felty's syndrome, both fully responsive solely to corticosteroids". Clinical Case Reports. 6 (3): 509–512. doi:10.1002/ccr3.1396. ISSN 2050-0904.
- ↑ Brochstein JA, Gillio AP, Ruggiero M, Kernan NA, Emanuel D, Laver J, Small T, O'Reilly RJ (December 1991). "Marrow transplantation from human leukocyte antigen-identical or haploidentical donors for correction of Wiskott-Aldrich syndrome". J. Pediatr. 119 (6): 907–12. PMID 1960605.
- ↑ Sanyi, Allen; Jaye, David L.; Rosand, Cecilia B.; Box, Amanda; Shanmuganathan, Chandrakasan; Waller, Edmund K. (2018). "Diagnosis of GATA2 haplo-insufficiency in a young woman prompted by pancytopenia with deficiencies of B-cell and dendritic cell development". Biomarker Research. 6 (1). doi:10.1186/s40364-018-0127-x. ISSN 2050-7771.
- ↑ Larroche, Claire (2012). "Hemophagocytic lymphohistiocytosis in adults: Diagnosis and treatment". Joint Bone Spine. 79 (4): 356–361. doi:10.1016/j.jbspin.2011.10.015. ISSN 1297-319X.
- ↑ Sarin, Shiv K.; Khanna, Rajeev (2014). "Non-cirrhotic Portal Hypertension". Clinics in Liver Disease. 18 (2): 451–476. doi:10.1016/j.cld.2014.01.009. ISSN 1089-3261.
- ↑ Aksoy, Evrim K.; Koklu, Seyfettin (2015). "Albendazole-Induced Cirrhosis Decompensation and Pancytopenia". Annals of Pharmacotherapy. 49 (8): 945–946. doi:10.1177/1060028015590178. ISSN 1060-0280.
- ↑ Düzenli Kar, Yeter; Özdemir, Zeynep C.; Kiral, Eylem; Kiliç Yildirim, Gonca; Dinleyici, Ener Ç.; Bör, Özcan (2018). "Hemophagocytic Lymphohystiocytosis Associated With Type Ia Glycogen Storage Disease". Journal of Pediatric Hematology/Oncology: 1. doi:10.1097/MPH.0000000000001208. ISSN 1077-4114.
- ↑ Tendas, Andrea; Niscola, Pasquale; Dentamaro, Teresa; Cupelli, Luca; Di Matteo, Gigliola; Finocchi, Andrea; Siniscalchi, Agostina; Fratoni, Stefano; Scimò, Teresa; Scaramucci, Laura; Giovannini, Marco; Ales, Micaela; Pio Perrotti, Alessio; de Fabritiis, Paolo (2010). "Pancytopenia and severe sepsis in an adult case of congenital X-linked agammaglobulinemia (XLA)". Annals of Hematology. 89 (9): 949–951. doi:10.1007/s00277-009-0891-7. ISSN 0939-5555.
- ↑ Santiago-Rodríguez, Eduardo; Mayor, Angel; Fernández-Santos, Diana; Hunter-Mellado, Robert (2015). "Profile of HIV-Infected Hispanics with Pancytopenia". International Journal of Environmental Research and Public Health. 13 (1): 38. doi:10.3390/ijerph13010038. ISSN 1660-4601.
- ↑ 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.
- ↑ Weston CF, Hall MJ (February 1987). "Pancytopenia and folate deficiency in alcoholics". Postgrad Med J. 63 (736): 117–20. PMC 2428237. PMID 3671238.
- ↑ Hudspeth M, Turner A, Miller N, Lazarchick J (May 2014). "Pancytopenia after allogeneic bone marrow transplant due to copper deficiency". J. Pediatr. Hematol. Oncol. 36 (4): 316–8. doi:10.1097/MPH.0b013e318290c644. PMID 23652881.
- ↑ Robinson SD, Cooper B, Leday TV (October 2013). "Copper deficiency (hypocupremia) and pancytopenia late after gastric bypass surgery". Proc (Bayl Univ Med Cent). 26 (4): 382–6. PMC 3777101. PMID 24082414.
- ↑ Dragusin, Roxana C.; Murray, Jean-Michel; Mallet, Dominique; Gonzalez, Hugo; Markou, Georges A. (2015). "Pancytopenia related to malnutrition during pregnancy". International Journal of Gynecology & Obstetrics. 130 (1): 86–87. doi:10.1016/j.ijgo.2015.02.020. ISSN 0020-7292.
- ↑ Kelm DJ, Torres KM, Sohail MR (August 2012). "46-year-old man with fevers, chills, and pancytopenia". Mayo Clin. Proc. 87 (8): 799–802. doi:10.1016/j.mayocp.2012.03.012. PMC 3498402. PMID 22862866.
- ↑ Davis SA, Krowchuk DP, Feldman SR (May 2014). "Prescriptions for a toxic combination: use of methotrexate plus trimethoprim-sulfamethoxazole in the United States". South. Med. J. 107 (5): 292–3. doi:10.1097/SMJ.0000000000000098. PMID 24937727.