Pancytopenia

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.