Pancytopenia
Template:Pancytopenia 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 pronounced reduction in the number of erythrocytes, all types of white blood cells and blood platelets that are circulating in the blood.
Pancytopenia is generally due to diseases affecting the bone marrow, although peripheral destruction of all lines of blood cells in hypersplenism (overactive spleen) is a recognized cause. Bone marrow problems causing pancytopenia include myelofibrosis, leukemia, aplastic anemia, and the malignant form of osteoporosis.
Chemotherapy for malignancies may also cause pancytopenia, if the drug or drugs used cause bone marrow suppression.
Increasingly, HIV (Human Immunodeficiency Virus) is itself a cause for pancytopenia. Rarely, drugs (antibiotics, anti hypertensive medication, heart medication) can cause pancytopenia.
Pancytopenia usually requires a bone marrow biopsy in order to distinguish among different causes.
Common Causes of Pancytopenia
- Aplastic anemia
- Myelodysplastic syndrome
- Leukemia
- Leishmaniasis
- Severe Folate or Vitamin B12 deficiency
- Paroxysmal nocturnal hemoglobinuria (Urine test)
- Finally overwhelming viral infections (HIV most common).
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical/Poisoning | No underlying causes |
| Dental | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | No underlying causes |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| 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
- Environmental/occupational (eg, benzene)
- Eosinophilic fasciitis
- Epstein-Barr virus Seronegative
- Ewing sarcoma
- Familial histiocytic reticulosis
- Familial monosomy 7
- Familial myelofibrosis
- Fanconi anaemia
- Flucytosine
- Folate deficiency
- Genotoxic therapy
- Germ cell tumors (embryonal dysgenesis)
- Glue vapors
- Glutathione synthase deficiency
- Gold
- Graft versus host disease
- Haemoglobin E disease
- Haemoglobin SC disease
- Hairy cell leukaemia
- Hematopoietic cell transplantation
- Hemoglobin H disease
- Hepatitis
- Hepatosplenic T-cell lymphoma
- Histiocytosis X
- Hodgkin lymphoma
- Human immunodeficiency virus (HIV)
- Hypersplenism
- Hypoplastic myelodysplastic syndromes
- Idarubicin
- Idiopathic
- indomethacin
- Ineffective erythropoiesis
- Intestinal lymphangiectasia
- Intrinsic factor deficiency (congenital)
- Iron deficiency
- Kwashiorkor
- Langerhans cell histiocytosis
- Large granular lymphocytic leukemia
- Lassa fever
- Legionella pneumophila
- Leucoerythroblastic anaemia
- Malabsorption syndrome
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- Malignant histiocytosis
- Marasmus
- Megaloblastic anaemia
- Melanoma
- Metastatic neoplasm
- Mutagen exposure
- Mutagen-detoxification (GSTq1-null)
- Mycobacterium tuberculosis
- Myelodysplastic syndrome
- Myelofibrosis
- Myeloma
- Myelpathic anemia
- Neurofibromatosis 1
- Niemann-Pick disease
- Non steroidal anti-inflammatory drugs (NSAIDs):
- Non-Hodgkin lymphoma
- Obesity
- Oklahoma tick fever
- Osteoclastoma
- Osteopetrosis lethal
- Osteopetrosis, autosomal recessive 2
- Osteosarcoma
- Paroxysmal nocturnal haemoglobinuria
- Parvovirus B19 infection
- phenacemide
- phenylbutazone,
- Plummer-Vinson syndrome
- Portal hypertension
- Pregnancy
- Prostate cancer
- propylthiouracil
- Q fever
- Renal failure, chronic
- Reticular dysgenesis
- Rheumatoid disease
- Severe combined immunodeficiency, T- B+ due to JAK3 deficiency
- Sickle cell disease
- sulfonamides,
- Systemic lupus erythematosus
- Thymoma
- Thyroid carcinoma
- Tobacco use
- Topoisomerase II interactive agents
- Trisomy 8 mosaicism
- Vitamin B12 deficiency
- Vitamin C deficiency
- Wiskott-Aldrich syndrome
- Xeroderma pigmentosum
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