Evaluation of pancytopenia differential diagnosis of. A reduction in all 3 types of cellular components in peripheral blood is termed pancytopenia and this involves anaemia, neutropenia, and thrombocytopenia. Jan 01, 20 pancytopenia is a common indication for bone marrow examination and can have numerous causes. Pancytopenia in a dog, abstract a 4yearold male, castrated, mixedbreed dog was presented to the colorado state university veterinary teaching hospital with a 1week history of polyuria, polydipsia, lethargy, fever, inappetence, weight loss, and soft mucoid stool.
Pdf the differential diagnosis and bone marrow evaluation. If someone is pancytopenic, all cell lines are low. Ards stands for acute respiratory distress syndrome. Become ambassador and add your answer pancytopenia diagnosis. The differential diagnosis and bone marrow evaluation of new.
Aplastic anemia pediatrics clerkship the university of. It is a striking feature of many serious and lifethreatening illnesses, ranging from simple druginduced bone marrow hypoplasia, megaloblastic anemia to fatal bone marrow aplasias and leukemias. Table 1071 differential diagnosis of pancytopenia harrisons textbook of internal medicine major causes of pancytopenia secondary to bone marrow failure uptodate major causes of acquired aplastic anemia uptodate despite cellular bm. A thoughtful history and physical examination along with focused laboratory studies are required to establish a diagnosis and select proper management. Doctor answers on symptoms, diagnosis, treatment, and more. One of the major challenges in pediatric hematology is the correct diagnosis of patients with pancytopenia and hypocellular bm. Anemia occurs when there are too few red blood cells in the blood. P53 gene deleted in subset of cases is common higher risk of histologic transformation differential diagnosis hairy cell leukemia. Differential for pancytopenia without splenomegaly includes aa, bone marrow failure leukemia, myelodysplastic syndromes, bone marrow infiltration by tumor or fibrosis, paroxysmal nocturnal hemoglobinuria, severe megaloblastic anemia, and overwhelming infection by hiv.
The term implies that the bone marrow is responsible for the cytopenias, with very few extramedullary diseases producing this constellation of hematologic abnormalities. Newonset pancytopenia outside this setting, in both children and. Jul, 2015 one of the major challenges in pediatric hematology is the correct diagnosis of patients with pancytopenia and hypocellular bm. Differential diagnosis and bone marrow evaluation of new. The purpose of this paper is to record a case of pancytopenia due to disseminated tuberculosis, and again to draw attention to the difficulties encountered in diagnosis. Defects in the stem cells or in the stroma or microenvironment of bone marrow can lead to bone marrow failure and pancytopenia. Degree of pancytopenia is influenced more by duration of infection than by its severity 27, 28. Exceptions are severe bacterial sepsis which can result in anemia of inflammatory disease, severe neutropenia with a left shift. Cytotoxic therapies, including myeloablative radiation therapy and chemotherapy, are common, but predictable, causes of pancytopenia in patients being treated systemically for neoplasia. Pancytopenia symptoms, diagnosis, treatments and causes. In most cases of pancytopenia, referral to a hematologist will be important for purposes of. Aplastic anemia is a syndrome of bone marrow failure characterized by peripheral pancytopenia and marrow hypoplasia.
Nursing diagnosis for pancytopenia answers on healthtap. To pass the quiz, you should understand the recommended treatment for pancytopenia and a side effect of pancytopenia treatment. Sle can present with pancytopenia when all the three cell lines are affected, however it is less common than isolated cytopenias. Pancytopenia is low levels of red blood cells, white blood cells, and platelets. Rarely, the disease may be congenital fanconi anemia. Pancytopenia is defined as anemia typically nonregenerative, neutropenia, and thrombocytopenia. If it appears that you truly have pancytopenia, the first step is often a bone marrow biopsy. Free, official information about 2012 and also 202015 icd9cm diagnosis code 284. Feb 03, 2020 pancytopenia is low levels of red blood cells, white blood cells, and platelets. Causes and risk factors in about half the cases of pancytopenia, the origin is unknown or idiopathic. Lupus flare vs macrophage activation syndrome amy mcghee, md introduction macrophage activation syndrome mas, first named in 1993, is a subcategory of hemophagocytic lymphohistiocytosis hlh, characterized by prolonged fever, hepatosplenomegaly, pancytopenia, liver dysfunction, and most. Exceptions are severe bacterial sepsis which can result in anemia of inflammatory disease. A structured approach to the diagnosis of thrombocytopenia involves an integration of clinical. Dr vishu p bhasin dcp resident, santosh medical college 2.
Pancytopenia is present in approximately 50% of patients with hairy cell leukemia at diagnosis. Pancytopenia increases your risk for infection and. A term used to describe a lack of all of the different types of blood cells red and white blood cells and blood platelets. Pancytopenia is a relatively common phenomenon encountered in clinical practice. Pancytopenia is a common indication for bone marrow examination and can have numerous causes. Although often normocytic, mild macrocytosis can also be observed in association with stress erythropoiesis and elevated fetal hemoglobin levels. This process of determining what is the basic problem is called a differential diagnosis. Aug 23, 2011 when i look up pancytopenia in my coding manual, im directed to 284. Pancytopenia occurs when a person has a decrease in all three blood cell types. Pancytopenia develops in later childhood at a median age of 3. Cancer, infections and toxins are some of the causes of pancytopenia.
See full list of 18 drug interactions causing pancytopenia. Unilineage marrow dysplasia with pancytopenia or pancytopenia can be associated with a multitude of disease states, some of which are life threatening. Pancytopenia is a common hematological problem with an extensive differential diagnosis, and still the optimal diagnostic approach to pancytopenia remains undefined. When i look up pancytopenia in my coding manual, im directed to 284. By contrast, pancytopenia is frequently associated with a hypocellular bone marrow, and the differential diagnosis includes acquired aplastic anemia, myelodysplastic syndrome, inherited bone marrow failure syndromes such as fanconi anemia and dyskeratosis congenita, and a variety of immunological disorders including hemophagocytic lymphohistiocytosis. Pancytopenia can be associated with a multitude of disease states, some of which are life threatening. Version version download 115 stock quota total files 1 file size 255. Peripheral pancytopenia is not a disease by itself. Pylori screening for inherited disorders, as indicated. Pancytopenia may be noted on a complete blood count cbc. Further relevant information on causes of pancytopenia may be found in. Aplastic anemia differential diagnoses medscape reference. Once infections and other more frequent conditions resulting in a transient suppression of hematopoieisis have been excluded, the main differential diagnosis includes saa, hypoplastic mds, and ibmfs, such as fa and dc. If someone us thrombocytopenic, the platelet count is low.
Evaluation of the adult with pancytopenia is discussed separately. A subset of patients experience a transient rise in platelet counts and later onset pancytopenia. Pdf pancytopenia a clinico haematological study of 200. Evaluation of pancytopenia differentials bmj best practice. The evaluation of a patient with pancytopenia requires a comprehensive approach and identifying the underlying cause can be challenging given the wide range of etiologies including drugs, autoimmune conditions, malignancies, infections, hemophagocytosis, and inheritable conditions. Major causes of pancytopenia in developing countries are megaloblastic anemia, parasitic infection, hypersplenism and aplastic anemia. Platelets stop the bleeding when you are cut or injured. During his stay, he showed a spectrum of interesting hematological findings, including severe pancytopenia on peripheral smear, hemophagocytosis, epithelioid cell. If rbcs are less then the condition is called anemia. Cytopenia is a reduction in the number of each type of peripheral blood cell.
An etiological reappraisal of pancytopenia largest. This is a decrease in all the cell lines of your blood. Thrombocytopenia in pregnancy deserves special consideration because of the possible consequences on the fetus. Check the full list of possible causes and conditions now. Red blood cells carry oxygen to all the organs and tissues of your body. Pdf pancytopenia a clinico haematological study of 200 cases. Clonal hematopoiesis of indeterminate potential chip refers to ch.
Idiopathic pancytopenia with hypocellular bone marrow that contains abundant fat is called aplastic pancytopenia or aplastic anemia. Normal adult marrow produces about 170x109 rbc 100x109 neutrophils 200x109 platelets daily. Disseminated intravascular coagulation contributes to pancytopenia in some patients. Pancytopenia is a reduction in the number of red blood cells, white blood cells, and platelets in the peripheral blood below the lower limits of the ageadjusted normal range for healthy people. White blood cells help your body fight infection by attacking and killing germs. Only a few systematic studies have been published on the topic of pancytopenia, although extensive studies have been done for its different etiological factors like aplastic. Pancytopenia is a reduction in the number of rbcs, wbcs and, platelets in the peripheral blood below the lower limits of the ageadjusted normal range for healthy people.
Pancytopenia medigoo health medical tests and free. Without treatment, it can lead to lifethreatening symptoms that affect the entire body such as oxygen shortage and immune system problems. The differential diagnosis and bone marrow evaluation of new onset pancytopenia. The code is not valid for the year 2020 for the submission of hipaacovered transactions. It is therefore the combination of anemia, leukopenia, and thrombocytopenia. Pancytopenia is a condition in which a persons body has too few red blood cells, white blood cells, and platelets. An etiological reappraisal of pancytopenia largest series. Pancytopenia means a disorder in which all 3 blood elements red blood cells, white blood cells and platelets are decreased than normal.
Which specialists are essential to meet, what tests are needed and other useful information for the diagnosis of pancytopenia. A first step in evaluating low levels of all cells is to repeat the cbc. Because of its ties to a wide range of illnesses, pancytopenia is a somewhat common blood cell problem. Each of these blood cell types has a different job in the body. Apr 02, 2017 the differential diagnosis and bone marrow evaluation of new onset pancytopenia. Pancytopenia is a relatively common hematological entity. As with all medical conditions, there may be many causal factors. A peripheral blood smear is then done to look further at each of the different types of cells. The differential diagnosis and bone marrow evaluation of. After stabilization, he was treated with mopp chemo therapy and patients symptoms gradually improved.
668 1411 1322 1283 247 1528 583 248 1445 1243 1089 1579 1205 512 1422 1104 957 127 1214 1251 806 1578 599 1126 1232 1669 234 1250 240 443 190 245 22 1266 551 1421 417 249 285