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Concept
Pancytopenia
Summary
Pancytopenia is a medical condition in which there is significant reduction in the number of almost all blood cells (red blood cells, white blood cells, platelets, monocytes, lymphocytes, etc.).
If only two parameters from the complete blood count are low, the term bicytopenia can be used. The diagnostic approach is the same as for pancytopenia.
Iatrogenic causes of pancytopenia include chemotherapy for malignancies if the drug or drugs used cause bone marrow suppression. Rarely, drugs (antibiotics, blood pressure medication, heart medication) can cause pancytopenia.
For example, the antibiotic chloramphenicol can cause pancytopenia in some individuals.
Rarely, pancytopenia may have other causes, such as mononucleosis or other viral diseases. Increasingly, HIV is itself a cause of pancytopenia.
Familial hemophagocytic syndrome
Aplastic anemia
Gaucher's disease
Metastatic carcinoma of bone
Multiple Myeloma
Overwhelming infections
Lymphoma
Myelofibrosis
Dyskeratosis congenita
Myelodysplastic syndrome
Leukemia
Leishmaniasis
Severe folate or vitamin B12 deficiency
Systemic lupus erythematosus
Paroxysmal nocturnal hemoglobinuria (blood test)
Viral infections (such as HIV, EBV; an undetermined virus is most common)
Alimentary toxic aleukia
Copper deficiency
Pernicious anemia
Medication
Hypersplenism
Osteopetrosis
Organic acidurias (Propionic Acidemia, Methylmalonic Aciduria, Isovaleric Aciduria)
Low dose arsenic poisoning
Sako disease (Myelodysplastic-cytosis)
Chronic radiation sickness
LIG4 syndrome
The mechanism of pancytopenia involves either haemopoiesis itself, decreasing blood cell productions in number (aplastic anemia), haemopoietic stem cells are displaced by malignant cells (Leukemia, lymphoma, MDS) or they are being pooled (sequestrated) (spleen)/destroyed (immune) outside bone marrow. The mechanisms for pancytopenia differ according to the etiology. For example, in hemophagocytic lymphohistiocytosis (HLH) there is marked inappropriate and ineffective T cell activation that leads to an increased hemophagocytic activity.
Official source
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