Pancytopenia
Template:Pancytopenia Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Pancytopenia is the pronounced reduction in the number of erythrocytes, all types of white blood cells and blood platelets that are circulating in the blood.
Pancytopenia is generally due to diseases affecting the bone marrow, although peripheral destruction of all lines of blood cells in hypersplenism (overactive spleen) is a recognized cause. Bone marrow problems causing pancytopenia include myelofibrosis, leukemia, aplastic anemia, and the malignant form of osteoporosis.
Chemotherapy for malignancies may also cause pancytopenia, if the drug or drugs used cause bone marrow suppression.
Increasingly, HIV (Human Immunodeficiency Virus) is itself a cause for pancytopenia. Rarely, drugs (antibiotics, anti hypertensive medication, heart medication) can cause pancytopenia.
Pancytopenia usually requires a bone marrow biopsy in order to distinguish among different causes.
Common Causes of Pancytopenia
- Aplastic anemia
- Myelodysplastic syndrome
- Leukemia
- Leishmaniasis
- Severe Folate or Vitamin B12 deficiency
- Paroxysmal nocturnal hemoglobinuria (Urine test)
- Finally overwhelming viral infections (HIV most common).
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical/Poisoning | No underlying causes |
| Dental | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | Phenylbutazone , phenacemide , Non steroidal anti-inflammatory drugs , indomethacin , Idarubicin , Gold , Flucytosine , Doxorubicin , Cytotoxic drugs and radiation , Colchicine toxicity , Clomipramine , Chloramphenicol , Carboplatin , carbamazepine , Busulphan , Azathioprine , Auranofin , Arsenicals , Alkylators , Alkylating antineoplastic agent , Alemtuzumab , Albendazole , Aclarubicin , sulfonamides , propylthiouracil |
| Ear Nose Throat | No underlying causes |
| Endocrine | Thyroid carcinoma |
| Environmental | Tobacco use , Environmental/occupational (eg, benzene) |
| Gastroenterologic | Portal hypertension , Intestinal lymphangiectasia , Hepatitis |
| Genetic | Wiskott-Aldrich syndrome , Trisomy 8 mosaicism , Severe combined immunodeficiency, T- B+ due to JAK3 deficiency , Niemann-Pick disease , Neurofibromatosis 1 , Mutagen-detoxification (GSTq1-null) , Mutagen exposure , Glutathione synthase deficiency , Genotoxic therapy , Fanconi anaemia , Familial monosomy 7 , Down syndrome , DNA repair deficiencies , Defect in synthesis of adenosylcobalamin , Chediak-Higashi disease , Ataxia telangiectasia |
| Hematologic | Sickle cell disease , Reticular dysgenesis , Paroxysmal nocturnal haemoglobinuria , Non-Hodgkin lymphoma , Myelpathic anemia,
Myeloma , Myelofibrosis , Myelodysplastic syndrome , Megaloblastic anaemia , Malignant histiocytosis , Leucoerythroblastic anaemia , Large granular lymphocytic leukemia , Langerhans cell histiocytosis , Ineffective erythropoiesis , Hypoplastic myelodysplastic syndromes , Hypersplenism , Hodgkin lymphoma , Histiocytosis X , Hepatosplenic T-cell lymphoma , Hemoglobin H disease , Hematopoietic cell transplantation , Hairy cell leukaemia , Haemoglobin SC disease , Haemoglobin E disease , Graft versus host disease , Familial myelofibrosis, Familial histiocytic reticulosis, Eosinophilic fasciitis , Cyclical neutropenia , Congenital neutropenia (Kostmann's or Shwachman-Diamond syndrome) , Common variable hypogammaglobulinaemia , Chronic myeloid leukaemia , Chronic lymphocytic leukaemia , Bleeding (Excessive), Autoimmune lymphoproliferative syndrome type 2 , Autoimmune lymphoproliferative syndrome type 1 , Aplastic anemia , Amegakaryocytic thrombocytopenia , Aggressive NK-cell leukemia, Acute lymphoblastic leukemia |
| Iatrogenic | No underlying causes |
| Infectious Disease | Q fever , Parvovirus B19 infection , Oklahoma tick fever , Mycobacterium tuberculosis , Legionella pneumophila , Lassa fever , Human immunodeficiency virus , Epstein-Barr virus Seronegative , Dengue , Brucellosis |
| Musculoskeletal/Orthopedic | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional/Metabolic | Vitamin C deficiency , Vitamin B12 deficiency , Marasmus , Malabsorption syndrome , Kwashiorkor , Iron deficiency ,
Intrinsic factor deficiency , Folate deficiency , Copper deficiency |
| Obstetric/Gynecologic | Pregnancy |
| Oncologic | Thymoma , Prostate cancer , Metastatic neoplasm , Melanoma , Germ cell tumors (embryonal dysgenesis) , Ewing sarcoma , Chondrosarcoma , Cancer treatment |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | No underlying causes |
| Psychiatric | Anorexia nervosa |
| Pulmonary | No underlying causes |
| Renal/Electrolyte | Renal failure, chronic |
| Rheumatology/Immunology/Allergy | Systemic lupus erythematosus , Rheumatoid disease , Osteopetrosis autosomal recessive 2 , Osteopetrosis lethal
Osteoclastoma , Ankylosing spondylitis |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | Topoisomerase II interactive agents , Plummer-Vinson syndrome , Obesity , Idiopathic , Glue vapors , Dyskeratosis congenita Shwachman-Diamond syndrome , Diamond-Blackfan anemia , Castleman disease, Bloom's syndrome |
Causes in Alphabetical Order