Pancytopenia: Difference between revisions

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==Causes==
==Causes==
===Life Threatening Causes===


===Common Causes===
===Common Causes===
* [[Aplastic anemia]]
* [[Aplastic anemia]]
* [[Myelodysplastic syndrome]]
* [[Myelodysplastic syndrome]]
* [[Leukemia]]
* [[Leukemia]]
* [[Leishmaniasis]]
* [[Leishmaniasis]]
 
* [[Folate deficiency]]
* Severe [[Folate]] or [[Vitamin B12 deficiency]]  
* [[Vitamin B12 deficiency]]  
 
* [[Paroxysmal nocturnal hemoglobinuria]]  
* [[Paroxysmal nocturnal hemoglobinuria]] ([[Urine test]])
* [[Viral infection]]s e.g. ([[HIV]] most common)
 
* Overwhelming [[viral infection]]s ([[HIV]] most common)
 
===Causes by Pathophysiology===
====Bone Marrow Failure====
* Insufficient production ([[aplastic anemia]])
* Inability of cells or mature ([[myelodysplasia]])
* Replacement of normal bone marrow with [[fibrosis]] ([[myelofibrosis]])
====Peripheral Sequestration/Destruction====
* [[Splenomegaly]]
* [[Hypersplenism]]
 
===Causes by Mode of Inheritance===
===Congenital===
*[[Cartilage hair hypoplasia]]
*[[Diamond-Blackfan syndrome]]
*[[Dubowitz syndrome]]
*[[Dyskeratosis congenita]]
*[[Familial aplastic anemia]]
*[[Fanconi's anemia]]
*[[Pearson syndrome]]
*[[Schwachman-Diamond syndrome]]
*[[TAR syndrome]]
 
===Acquired===
*[[Albers-Schonberg disease]]
*[[Banti's Syndrome]]
*[[Bone marrow]] [[tumor]]
*[[Cirrhosis]]
*[[Drug]]s/[[Toxins]]
*[[Felty's Syndrome]]
*[[Gaucher's Disease]]
*[[Graft-versus-host disease]]
*[[Infection]]s
*[[Kala-Azar]]
*[[Leukemia]]
*[[Lymphoma]]
*[[Lymphoproliferative Disorders]]
*[[Myelodysplastic syndrome]]
*[[Myelofibrosis]]
*[[Niemann-Pick Disease]]
*[[Osteoporosis]]
*[[Pernicious anemia]]
*[[Reticulosis]]
*[[Sarcoidosis]]
*[[Thymoma]]
*[[Tuberculosis]]


===Causes by Organ System===
===Causes by Organ System===
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===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
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{{col-begin|width=84%}}
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{{col-break|width=33%}}
*Aclarubicin
*Aclarubicin


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*[[Xeroderma pigmentosum]]
*[[Xeroderma pigmentosum]]
{{col-end}}
===Causes by Pathophysiology===
====Bone Marrow Failure====
* Insufficient production ([[aplastic anemia]])
* Inability of cells or mature ([[myelodysplasia]])
* Replacement of normal bone marrow with [[fibrosis]] ([[myelofibrosis]])
====Peripheral Sequestration/Destruction====
* [[Splenomegaly]]
* [[Hypersplenism]]


{{col-end}}
===Causes by Mode of Inheritance===
===Congenital===
*[[Cartilage hair hypoplasia]]
*[[Diamond-Blackfan syndrome]]
*[[Dubowitz syndrome]]
*[[Dyskeratosis congenita]]
*[[Familial aplastic anemia]]
*[[Fanconi's anemia]]
*[[Pearson syndrome]]
*[[Schwachman-Diamond syndrome]]
*[[TAR syndrome]]
 
===Acquired===
*[[Albers-Schonberg disease]]
*[[Banti's Syndrome]]
*[[Bone marrow]] [[tumor]]
*[[Cirrhosis]]
*[[Drug]]s/[[Toxins]]
*[[Felty's Syndrome]]
*[[Gaucher's Disease]]
*[[Graft-versus-host disease]]
*[[Infection]]s
*[[Kala-Azar]]
*[[Leukemia]]
*[[Lymphoma]]
*[[Lymphoproliferative Disorders]]
*[[Myelodysplastic syndrome]]
*[[Myelofibrosis]]
*[[Niemann-Pick Disease]]
*[[Osteoporosis]]
*[[Pernicious anemia]]
*[[Reticulosis]]
*[[Sarcoidosis]]
*[[Thymoma]]
*[[Tuberculosis]]


==References==
==References==

Revision as of 15:10, 9 March 2015

Pancytopenia is not equivalent with bone marrow suppression. Pancytopenia is a lab finding that may related to either bone marrow suppression or peripheral sequestration/destruction. For details about bone marrow suppression click here.

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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 reduction in numbers of all three bone marrow cell types (RBCs + WBCs + platelets). It is not a disease, but rather a lab finding that may related to 1) bone marrow suppression caused by either insufficient production (aplastic anemia), inability of cells or mature (myelodysplasia), or replacement of normal bone marrow with fibrosis (myelofibrosis) or 2) peripheral sequestration/destruction that is not related to the bone marrow (e.g. splenomegaly or hypersplenism). HIV (Human Immunodeficiency Virus) is itself a cause for pancytopenia. Chemotherapy is associated with pancytopenia. Pancytopenia usually requires a bone marrow biopsy in order to distinguish among different causes.

Causes

Life Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Acetaminophen and Oxycodone, Aclarubicin, Albendazole, Alemtuzumab, Alkylating antineoplastic agent, Alkylators, Arsenicals, Auranofin, Azathioprine, Aztreonam, Boceprevir, Busulphan, carbamazepine, Carboplatin, Cefadroxil, Ceftazidime, Certolizumab pegol, Chlorpromazine, Chloramphenicol, Chlorpropamide, Cidofovir, Clomipramine, Colchicine toxicity, Cytotoxic drugs and radiation, Dactinomycin, Doxorubicin, Ethosuximide, Febuxostat, Flucytosine, Gold, Gemifloxacin mesylate, Idarubicin, indomethacin , Interferon beta- 1a, Lincomycin Hydrochloride Minocycline hydrochloride, Non steroidal anti-inflammatory drugs, Ofatumumab, Omacetaxine, Oxaprozin, Oxcarbazepine, Penicillamine, phenacemide , Phenylbutazone, Piperacillin, Pralatrexate, propylthiouracil , Pyrimethamine, Rabeprazole, Radium chloride, sulfonamides, Tamoxifen, Tolbutamide, Tolazamide, Trifluoperazine, Trimethadione, Thiothixene, Valganciclovir hydrochloride
Ear Nose Throat No underlying causes
Endocrine Thyroid carcinoma
Environmental Tobacco use, Environmental/occupational (eg, benzene)
Gastroenterologic Portal hypertension, Intestinal lymphangiectasia, Hepatitis
Genetic Ataxia telangiectasia, Barth syndrome, Chediak-Higashi disease, defect in synthesis of adenosylcobalamin, DNA repair deficiencies, Down syndrome, Dubowitz syndrome, familial monosomy 7, Fanconi anaemia, genotoxic therapy, glutathione synthase deficiency, glycogen storage diseases, mutagen exposure, mutagen-detoxification (GSTq1-null), neurofibromatosis 1, Niemann-Pick disease, Nijmege breakage syndrome, Noonan syndrome, organic acid metabolism defect, Pearson syndrome, Seckel syndrome, Severe combined immunodeficiency, T- B+ due to JAK3 deficiency, trisomy 8 mosaicism, Wiskott-Aldrich syndrome
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

Causes by Pathophysiology

Bone Marrow Failure

Peripheral Sequestration/Destruction

Causes by Mode of Inheritance

Congenital

Acquired

References


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