It is a decrease in all three cellular elements of peripheral blood leading to anemia, leucopenia and thrombocytopenia1. The diagnostic approach to an adult patient with pancytopenia will be discussed here. The main causes of pancytopenia are aplastic anemia, hyper. The severity of pancytopenia and the underlying pathology determine the management and. Thrombocytopenia is defined as a platelet count of less than 150. It is often discovered incidentally when it is often discovered incidentally when obtaining a complete blood count. The term cytopenia reduction in either of the cellular component of blood. Approach to pancytopenia moderator dr vishal gupta md medicine. However the approach to manage patients with pancytopenia in the current era of genomics is not well defined in the literature and is widely variable in practice. Materials and methods the present prospective study was undertaken for a period of 2 years, from september 2005 to september 2007, at hematology unit, department of pathology, j. Out of 40 patients of this age group 20 had megaloblastic anemia and 18 out of these 20 patients 90% were with grade ii iii malnutrition p valve 0. Pancytopenia is not a disease but a triad of findings that may result from a number of disease processes. Pancytopenia usually presents with symptoms of bone marrow failure such as pallor, dyspnea, bleeding, bruising.
Pancytopenia is a common hematological problem with an extensive differential diagnosis, and the optimal diagnostic approach to pancytopenia remains undefined. Pancytopenia in a child should alert the clinician to the possibility of disorders such as leukemia, aplastic anemia, or disseminated neuroblastoma. There are varying trends in its clinical pattern, treatment modalities, and outcome. Exceptions are severe bacterial sepsis which can result in anemia of inflammatory disease, severe neutropenia with a left shift. Pancytopenia is an important hematological problem encountered in our daytoday clinical practice.
In most cases of pancytopenia, referral to a hematologist will be important for purposes of diagnosis andor management. Rarely, the disease may be congenital fanconi anemia. Feb 03, 2020 the treatment of pancytopenia depends on the cause. How to approach thrombocytopenia hematology american. May 23, 2017 pancytopenia is a condition in which a persons body has too few red blood cells, white blood cells, and platelets. Pancytopenia is low levels of red blood cells, white blood cells, and platelets. Pancytopenia is defined as anemia typically nonregenerative, neutropenia, and thrombocytopenia. A blood transfusion can help increase red blood cell, white blood cell, and platelet levels. On conclusion, aplastic anemia was the most common cause of pancytopenia in our study predominantly affecting young adult males. Peripheral cytopenia is defined as reduction in either of the cellular elements of blood, i. Find powerpoint presentations and slides using the power of, find free presentations research about pancytopenia ppt. A structured approach to the diagnosis of thrombocytopenia involves an integration of clinical findings and appropriate support from the laboratory and other medical disciplines.
Each of these blood cell types has a different job in the body. Diagnostic approach to a patient with suspected anaemia as anaemia may manifest in a wide range of disorders, a streamlined diagnostic approach is vital fig. Approach to the adult with pancytopenia view in chinese one cause of pancytopenia. The sole purpose of this website is to help internal medicine residents, medical students, and attendings to learn and teach medicine at its best. Physical and systemic examination was unremarkable. Pancytopenia chettinad health city medical journal. Dr vishu p bhasin dcp resident, santosh medical college 2.
Pancytopenia in a patient with graves disease med j malaysia vol 68 no 4 august 20 373 achieved euthyroid status with either antithyroid medication or radioiodine therapy. Cytopenia is a reduction in the number of each type of peripheral blood cell. The term implies that the bone marrow is responsible for the cytopenias, with very few extramedullary diseases producing this constellation of hematologic abnormalities. How to approach neutropenia hematology american society. Treatment of the pancytopenia includes supportive care for infections, bleeding and. Version version download 115 stock quota total files 1 file size 255. A 55yearold male presented with generalized body weakness and few episodes of malena for last one year. Pancytopenia approach pancytopenia is a reduction in the number of red cells, white cells neutrophils and platelets in the peripheral blood below the lower limits of the ageadjusted normal range for healthy people. A reduction in all 3 types of cellular components in peripheral blood is termed pancytopenia and this involves anaemia, neutropenia, and thrombocytopenia.
Pdf on mar 31, 2017, murtaza kamal and others published approach to pancytopenia find, read and cite all the research you need on researchgate. Infective etiology was the cause of bicytopenia pancytopenia in 19%, aplastic anemia. Choose from 41 different sets of pancytopenia flashcards on quizlet. Many disease processes involve the bone marrow primarily or secondarily resulting in pancytopenia.
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. Dec 08, 2012 thrombocytopenia in pregnancy deserves special consideration because of the possible consequences on the fetus. Pancytopenia is a medical condition in which there is a reduction in the number of red and white blood cells, as well as platelets. This lesson covers the definition of pancytopenia and compares it to aplastic anemia, a condition that presents itself in a similar way. Pancytopenia medigoo health medical tests and free health. Detection of pancytopenia associated with clinical. Approach to severe anemia in children in the emergency room. Pdf herbal approach in the treatment of pancytopenia. Etiological spectrum of pancytopenia bicytopenia in. Platelets stop the bleeding when your child is cut or injured. The approach outlined here is based on the abovementioned classification, clinical scenario and full blood count fbc findings. Acquired stem cell disorder due to dysfunction of the gpi linker protein. The evaluation of a patient with pancytopenia requires a comprehensive approach and identifying the underlying.
Abnormal increase or decrease granulation in neutrophil 5. Pancytopenia means a disorder in which all 3 blood elements red blood cells, white blood cells and platelets are decreased than normal. Instead, a blood transfusion may keep you safe until the cause of pancytopenia is known. Anemia of chronic disease anemia of chronic disease is mostly secondary. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Learn pancytopenia with free interactive flashcards. Dec 08, 2012 such an approach will help to differentiate the disorder from scn that may at times share the same elane mutation. Red blood cells carry oxygen to all the organs and tissues in your childs body.
Pancytopenia is defined as decrease in red blood cells, white blood cells and platelets. Postulated mechanisms of pancytopenia include reduced production of hematopoietic cells from the marrow 1 and increased destruction or. White blood cells help your childs body fight infection by attacking and killing germs. Mutations in piga gene lead to reduction or absence of glycosylphosphatidylinositol gpi erythrocyte anchoring protein. The evaluation of isolated neutropenia, anemia, and thrombocytopenia are presented separately. See approach to the adult with unexplained neutropenia and approach to the adult with anemia and approach to the adult with unexplained thrombocytopenia.
Anemia is defined as a hemoglobin hb level pancytopenia bone marrow irradiation chemotherapyespecially anthracyclines, methotrexate. Pancytopenia is a relatively common hematological entity. Cyclic neutropenia, unlike the autosomaldominant form of congenital neutropenia associated with mutations of elane, is not associated with an increased risk for leukemia or myelodysplasia. It discusses its known causes, the signs and symptoms, and. The evaluation of isolated neutropenia, anemia, and.
Treatment of a disorder that causes pancytopenia eg, chemotherapy for an underlying lymphoma may further exacerbate cytopenias. The evaluation of a patient with pancytopenia requires a comprehensive approach and identifying the underlying cause can be challenging. By doing so, i hope that im residents will enjoy medicine, and medical students will find interest in internal medicine. Pancytopenia is an important clinicohematological entity encountered in our daytoday clinical 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.
Pancytopenia is a condition in which a persons body has too few red blood cells, white blood cells, and platelets. Pancytopenia is a disorder associated with decrease in number of all three major formed elements of blood red blood cells. 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. If only two parameters from the complete blood count are low, the term bicytopenia can be used.
Causes of pancytopenia normal adult marrow produces about 170x109 rbc 100x109 neutrophils 200x109 platelets daily defects in the stem cells or in the stroma or microenvironment of bone marrow can lead to bone marrow failure and pancytopenia. The diagnostic approach is the same as for pancytopenia. Pancytopenia is a relatively common phenomenon encountered in clinical practice. Pdf pancytopenia is a health condition in which there is a reduction in the amount of leucocytes, erythrocytes and thrombocytes. Thrombocytopenia american academy of family physicians. Bicytopenia is reduction in any of the two cell lines and pancytopenia is reduction in all the three. Jan 01, 2018 however the approach to manage patients with pancytopenia in the current era of genomics is not well defined in the literature and is widely variable in practice.