Pancytopenia resident survival guide: Difference between revisions
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Revision as of 15:30, 14 November 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sanjana Nethagani, M.B.B.S.[2]
Synonyms and keywords: Approach to pancytopenia, Approach to anemia
| Pancytopenia Resident Survival Guide Microchapters |
|---|
| Overview |
| Causes |
| Diagnosis |
| Treatment |
| Do's |
| Don'ts |
Overview
Pancytopenia is described as a decrease in the 3 cell lines which are red blood cells, white blood cells and platelets. Clinically, pancytopenia is defined as hemoglobin< 9gm, white blood cell count< 4,000/cmm and platelets < 100,000/cmm. It can be due to decreased production in the bone marrow or increased destruction of cells in the periphery. Pancytopenia can also be caused due to drugs such as chemotherapy agents. Treatment involves identifying the underlying cause and appropriate therapy.
Causes
Decreased production of cells
Increased peripheral destruction
Other causes
- Chemotherapy
- Parvovirus B-19 infection
- Autoimmune conditions
- Human immunodeficiency virus infection
- Tuberculosis
- Lymphoma
For a full list of pancytopenia causes, click here.
Diagnosis
Diagnosis of pancytopenia is outlined in the algorithm below.
| Thorough history | |||||||||||||||||||||||||
Manifestations of decrease in each cell line Decrease in RBCs ❑ dyspnea ❑ fatigue ❑ pallor ❑ chest pain Decrease in WBCs ❑ increased susceptibility to infections ❑ fever Decrease in platelets ❑ petechiae ❑ easy bruising ❑ bleeding | |||||||||||||||||||||||||
Treatment
Do's
- Screen for infections like hepatitis, HIV, Parvovirus-B19, Epstein Barr virus, etc.
- Periodic, regular blood tests must be done for patients on methotrexate or other marrow suppressing drugs.
- Patients who have pancytopenia must be counselled against the use of drugs such as aspirin and other NSAIDs which may cause bleeding.