Pancytopenia: Difference between revisions
ClaireLewis (talk | contribs) (→Causes) |
No edit summary |
||
| Line 3: | Line 3: | ||
==Clinical Features== | ==Clinical Features== | ||
*Signs/symptoms of anemia (e.g. fatigue, dyspnea, tachycardia, pallor) | *Signs/symptoms of anemia (e.g. fatigue, dyspnea, tachycardia, pallor) | ||
*Signs/symptoms of thrombocytopenia (e.g. petechiae/purpura, mucosal bleeding, GI bleed, hematuria, intracranial hemorrhage) | *Signs/symptoms of thrombocytopenia (e.g. petechiae/purpura, mucosal bleeding, GI bleed, hematuria, intracranial hemorrhage) | ||
*Signs/symptoms of leukopenia (e.g. recurrent, severe, or opportunistic infection) | *Signs/symptoms of leukopenia (e.g. recurrent, severe, or opportunistic infection) | ||
==Causes== | ===Causes=== | ||
*[[Acute leukemia]] | *[[Acute leukemia]] | ||
*[[Myelodysplastic syndrome]], myelofibrosis | *[[Myelodysplastic syndrome]], myelofibrosis | ||
| Line 34: | Line 33: | ||
==Evaluation== | ==Evaluation== | ||
*CBC Findings: Low hemoglobin/hematocrit, platelets, and white blood cell count | |||
===Aditional Considerations=== | |||
*Evaluate for causes of pancytopenia | *Evaluate for causes of pancytopenia | ||
**Drug history, infectious work-up, smear, malignancy work-up | **Drug history, infectious work-up, smear, malignancy work-up | ||
Revision as of 10:46, 8 September 2016
Background
Clinical Features
- Signs/symptoms of anemia (e.g. fatigue, dyspnea, tachycardia, pallor)
- Signs/symptoms of thrombocytopenia (e.g. petechiae/purpura, mucosal bleeding, GI bleed, hematuria, intracranial hemorrhage)
- Signs/symptoms of leukopenia (e.g. recurrent, severe, or opportunistic infection)
Causes
- Acute leukemia
- Myelodysplastic syndrome, myelofibrosis
- Aplastic anemia
- Infiltrative disease (e.g. lymphoma, multiple myeloma, metastatic carcinoma)
- Paroxysmal nocturnal hemoglobinuria
- Drugs/treatments (* drugs more commonly associated with pancytopenia)
- Bone marrow irradiation*
- Chemotherapy* (especially anthracyclines, methotrexate)
- Anti-inflammatories (rituximab*, sulfasalazine*, colchicine, azathioprine, methotrexate)
- Antimicrobials (chloramphenicol, gancyclovir, penicillin G*, dapsone*, quinine
- Thiomides (propythiouricil*, methimazole*, carbimazole)
- Antipsychotics (clozapine*, olanzapine
- Procainamide*
- Cyclophosphamide
- Antiepileptics ([[phenytoin], carbamazepine, phenobarbital)
- Infection
- Tuberculosis
- AIDS
- Leishmaniasis, brucellosis, histoplasmosis.
- Viruses causing aplastic anemia (hepatitis, Epstein-Barr virus, HIV, parvovirus B19)
- Systemic lupus erythematosus
- Hypersplenism
- Acute radiation syndrome
Evaluation
- CBC Findings: Low hemoglobin/hematocrit, platelets, and white blood cell count
Aditional Considerations
- Evaluate for causes of pancytopenia
- Drug history, infectious work-up, smear, malignancy work-up
- Evaluate for dangerous sequalae
- See evaluation of anemia, thrombocytopenia, neutropenia
Management
- See management of anemia, thrombocytopenia, neutropenia
- Consider appropriate consults (e.g. heme/onc, infectious disease)