Aplastic anemia differential diagnoses medscape reference. Apr 02, 2017 the differential diagnosis and bone marrow evaluation of new onset pancytopenia. Peripheral pancytopenia is not a disease by itself. Idiopathic pancytopenia with hypocellular bone marrow that contains abundant fat is called aplastic pancytopenia or aplastic anemia. One of the major challenges in pediatric hematology is the correct diagnosis of patients with pancytopenia and hypocellular bm.
Exceptions are severe bacterial sepsis which can result in anemia of inflammatory disease. Although often normocytic, mild macrocytosis can also be observed in association with stress erythropoiesis and elevated fetal hemoglobin levels. Aug 23, 2011 when i look up pancytopenia in my coding manual, im directed to 284. To pass the quiz, you should understand the recommended treatment for pancytopenia and a side effect of pancytopenia treatment. Pancytopenia may be noted on a complete blood count cbc. Nursing diagnosis for pancytopenia answers on healthtap.
Aplastic anemia is a syndrome of bone marrow failure characterized by peripheral pancytopenia and marrow hypoplasia. Pancytopenia can be associated with a multitude of disease states, some of which are life threatening. Pancytopenia symptoms, diagnosis, treatments and causes. Pancytopenia increases your risk for infection and. White blood cells help your body fight infection by attacking and killing germs. Pdf pancytopenia a clinico haematological study of 200. Causes and risk factors in about half the cases of pancytopenia, the origin is unknown or idiopathic. Lupus flare vs macrophage activation syndrome amy mcghee, md introduction macrophage activation syndrome mas, first named in 1993, is a subcategory of hemophagocytic lymphohistiocytosis hlh, characterized by prolonged fever, hepatosplenomegaly, pancytopenia, liver dysfunction, and most. Evaluation of pancytopenia differentials bmj best practice.
In most cases of pancytopenia, referral to a hematologist will be important for purposes of. Pancytopenia means a disorder in which all 3 blood elements red blood cells, white blood cells and platelets are decreased than normal. Free, official information about 2012 and also 202015 icd9cm diagnosis code 284. Differential for pancytopenia without splenomegaly includes aa, bone marrow failure leukemia, myelodysplastic syndromes, bone marrow infiltration by tumor or fibrosis, paroxysmal nocturnal hemoglobinuria, severe megaloblastic anemia, and overwhelming infection by hiv. Pancytopenia develops in later childhood at a median age of 3. Disseminated intravascular coagulation contributes to pancytopenia in some patients. Red blood cells carry oxygen to all the organs and tissues of your body. Cancer, infections and toxins are some of the causes of pancytopenia. Platelets stop the bleeding when you are cut or injured. Differential diagnosis and bone marrow evaluation of new. Causes causes of pancytopenia inherit ed acquir ed 5 6. Pancytopenia is a common indication for bone marrow examination and can have numerous causes. Dr vishu p bhasin dcp resident, santosh medical college 2. Ards stands for acute respiratory distress syndrome.
Pylori screening for inherited disorders, as indicated. As with all medical conditions, there may be many causal factors. Although pancytopenia appears to be a rare presentation of tuberculosis, it is advised to always consider tuberculosis as differential diagnosis in patients presenting with pancytopenia, unexplained pyrexia and weight loss. An etiological reappraisal of pancytopenia largest series. Jan 01, 20 pancytopenia is a common indication for bone marrow examination and can have numerous causes. A reduction in all 3 types of cellular components in peripheral blood is termed pancytopenia and this involves anaemia, neutropenia, and thrombocytopenia. Reticulocyte count to determine if bone marrow is regenerative. The differential diagnosis and bone marrow evaluation of new onset pancytopenia. When i look up pancytopenia in my coding manual, im directed to 284. The differential diagnosis and bone marrow evaluation of. Degree of pancytopenia is influenced more by duration of infection than by its severity 27, 28.
A structured approach to the diagnosis of thrombocytopenia involves an integration of clinical. Pancytopenia is a relatively common phenomenon encountered in clinical practice. May 23, 2017 pancytopenia is a condition in which a persons body has too few red blood cells, white blood cells, and platelets. The purpose of this paper is to record a case of pancytopenia due to disseminated tuberculosis, and again to draw attention to the difficulties encountered in diagnosis. Sle can present with pancytopenia when all the three cell lines are affected, however it is less common than isolated cytopenias. If someone is pancytopenic, all cell lines are low. Further relevant information on causes of pancytopenia may be found in. Thrombocytopenia in pregnancy deserves special consideration because of the possible consequences on the fetus.
Normal adult marrow produces about 170x109 rbc 100x109 neutrophils 200x109 platelets daily. Version version download 115 stock quota total files 1 file size 255. Pancytopenia is a relatively common hematological entity. Rarely, the disease may be congenital fanconi anemia. A term used to describe a lack of all of the different types of blood cells red and white blood cells and blood platelets. 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. Because of its ties to a wide range of illnesses, pancytopenia is a somewhat common blood cell problem. Pancytopenia is a common hematological problem with an extensive differential diagnosis, and still the optimal diagnostic approach to pancytopenia remains undefined. Check the full list of possible causes and conditions now. Pancytopenia in a dog, abstract a 4yearold male, castrated, mixedbreed dog was presented to the colorado state university veterinary teaching hospital with a 1week history of polyuria, polydipsia, lethargy, fever, inappetence, weight loss, and soft mucoid stool. Pancytopenia is low levels of red blood cells, white blood cells, and platelets. Feb 03, 2020 pancytopenia is low levels of red blood cells, white blood cells, and platelets.
It is therefore the combination of anemia, leukopenia, and. Clonal hematopoiesis of indeterminate potential chip refers to ch. Pancytopenia is a condition in which a persons body has too few red blood cells, white blood cells, and platelets. By contrast, pancytopenia is frequently associated with a hypocellular bone marrow, and the differential diagnosis includes acquired aplastic anemia, myelodysplastic syndrome, inherited bone marrow failure syndromes such as fanconi anemia and dyskeratosis congenita, and a variety of immunological disorders including hemophagocytic lymphohistiocytosis. Pdf the differential diagnosis and bone marrow evaluation. If someone us thrombocytopenic, the platelet count is low. Jul, 2015 one of the major challenges in pediatric hematology is the correct diagnosis of patients with pancytopenia and hypocellular bm. Aplastic anemia pediatrics clerkship the university of. Pancytopenia is a reduction in the number of red blood cells, white blood cells, and platelets in the peripheral blood below the lower limits of the ageadjusted normal range for healthy people. Become ambassador and add your answer pancytopenia diagnosis. This process of determining what is the basic problem is called a differential diagnosis. Which specialists are essential to meet, what tests are needed and other useful information for the diagnosis of pancytopenia. An etiological reappraisal of pancytopenia largest.
Without treatment, it can lead to lifethreatening symptoms that affect the entire body such as oxygen shortage and immune system problems. Doctor answers on symptoms, diagnosis, treatment, and more. After stabilization, he was treated with mopp chemo therapy and patients symptoms gradually improved. Exceptions are severe bacterial sepsis which can result in anemia of inflammatory disease, severe neutropenia with a left shift. The term implies that the bone marrow is responsible for the cytopenias, with very few extramedullary diseases producing this constellation of hematologic abnormalities. Cytotoxic therapies, including myeloablative radiation therapy and chemotherapy, are common, but predictable, causes of pancytopenia in patients being treated systemically for neoplasia. Table 1071 differential diagnosis of pancytopenia harrisons textbook of internal medicine major causes of pancytopenia secondary to bone marrow failure uptodate major causes of acquired aplastic anemia uptodate despite cellular bm. Pancytopenia is present in approximately 50% of patients with hairy cell leukemia at diagnosis. P53 gene deleted in subset of cases is common higher risk of histologic transformation differential diagnosis hairy cell leukemia. Anemia occurs when there are too few red blood cells in the blood. The differential diagnosis and bone marrow evaluation of new. A subset of patients experience a transient rise in platelet counts and later onset pancytopenia. Pancytopenia medigoo health medical tests and free.
Early diagnosis with genetic testing is crucial for management, preventive care and screening of other family members. 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. Only a few systematic studies have been published on the topic of pancytopenia, although extensive studies have been done for its different etiological factors like aplastic. Defects in the stem cells or in the stroma or microenvironment of bone marrow can lead to bone marrow failure and pancytopenia.
Once infections and other more frequent conditions resulting in a transient suppression of hematopoieisis have been excluded, the main differential diagnosis includes saa, hypoplastic mds, and ibmfs, such as fa and dc. The code is not valid for the year 2020 for the submission of hipaacovered transactions. Pdf pancytopenia a clinico haematological study of 200 cases. During his stay, he showed a spectrum of interesting hematological findings, including severe pancytopenia on peripheral smear, hemophagocytosis, epithelioid cell.
If rbcs are less then the condition is called anemia. 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. A peripheral blood smear is then done to look further at each of the different types of cells. Each of these blood cell types has a different job in the body.
Pancytopenia occurs when a person has a decrease in all three blood cell types. A thoughtful history and physical examination along with focused laboratory studies are required to establish a diagnosis and select proper management. Major causes of pancytopenia in developing countries are megaloblastic anemia, parasitic infection, hypersplenism and aplastic anemia. Dec 05, 2018 aplastic anemia is a syndrome of bone marrow failure characterized by peripheral pancytopenia and marrow hypoplasia. Evaluation of pancytopenia differential diagnosis of.