Pancytopenia

Causes

Appropriate Tests

 

Pancytopenia is a reduction in peripheral blood red cells, white cells and platelets.

Review clinical findings. Full blood count, Blood film, White cell count differential, Reticulocyte count, autoimmune profile, viral/other microbial serology.

Bone marrow aspiration and trephine biopsy if aetiology uncertain, or if confirmation required.

Cytogenetics and chromosome breakage studies may be indicated. See also Aplastic anaemia.

Bone marrow failure

 

Aplastic anaemia

 

Cytotoxic drugs

Thiopurine methyltransferase.

Irradiation

 

Viral infections, especially
  • Parvovirus B19 infection
  • HIV infection

 

Myelodysplasia

See Myelodysplastic syndromes

Paroxysmal nocturnal haemoglobinuria (PNH)

 

Bone marrow infiltration

 

Disseminated carcinoma

See also Leucoerythroblastic anaemia

Acute leukemia

 

Miliary tuberculosis

See Tuberculosis

Primary myelofibrosis

 

Lymphoma

 

Hairy cell leukaemia

 

Plasma cell myeloma

 

Lysosomal storage diseases

 

Gaucher disease 

Molecular genetics - genetic disorders.

Niemann Pick disease

 

Ineffective haemopoiesis

 

Megaloblastic anaemia

 

Myelodysplasia

See Myelodysplastic syndromes

Paroxysmal nocturnal haemoglobinuria

 

Hypersplenism

 

Immune

 

SLE

 

Drugs, especially

  • Phenacetin
  • PAS
  • Sulphonamides
  • Quinidine