Pancytopenia: Difference between revisions
ClaireLewis (talk | contribs) (Created page with "==Background== *Anemia + Thrombocytopenia + Leukopenia ==Clinical Features== *Low hemoglobin/hematocrit, platelets, and white blood cell count *Signs/symptoms of...") |
ClaireLewis (talk | contribs) (→Causes) |
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*Infiltrative disease (e.g. [[lymphoma]], [[multiple myeloma]], metastatic carcinoma) | *Infiltrative disease (e.g. [[lymphoma]], [[multiple myeloma]], metastatic carcinoma) | ||
*[[Paroxysmal nocturnal hemoglobinuria]] | *[[Paroxysmal nocturnal hemoglobinuria]] | ||
*Drugs/treatments (* | *Drugs/treatments (* drugs more commonly associated with pancytopenia) | ||
**Bone marrow irradiation* | **Bone marrow irradiation* | ||
**Chemotherapy* (especially anthracyclines, [[methotrexate]]) | **Chemotherapy* (especially anthracyclines, [[methotrexate]]) | ||
**Anti-inflammatories (rituximab*, sulfasalazine*, [[colchicine]], [[azathioprine]], [[methotrexate]]) | **Anti-inflammatories (rituximab*, sulfasalazine*, [[colchicine]], [[azathioprine]], [[methotrexate]]) | ||
**Antimicrobials ([[chloramphenicol]], [[gancyclovir]], penicillin G*, [[dapsone]]*, quinine | **Antimicrobials ([[chloramphenicol]], [[gancyclovir]], penicillin G*, [[dapsone]]*, quinine | ||
**Thiomides (propythiouricil*, methimazole*, carbimazole) | **Thiomides (propythiouricil*, methimazole*, carbimazole) | ||
**[[Antipsychotics]] ([[clozapine]]*, [[olanzapine]] | **[[Antipsychotics]] ([[clozapine]]*, [[olanzapine]] | ||
**[[Procainamide]]* | **[[Procainamide]]* | ||
**Cyclophosphamide | |||
**[[Antiepileptics]] ([[phenytoin], [[carbemazepime]], [[phenobarbital]]) | |||
*Infection | *Infection | ||
**[[Tuberculosis]] | **[[Tuberculosis]] | ||
Revision as of 22:52, 4 September 2016
Background
Clinical Features
- Low hemoglobin/hematocrit, platelets, and white blood cell count
- 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], carbemazepime, 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
- 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)