Pancytopenia

• What is pancytopenia characterised by?

  Decreased levels of 3 major cellular components of blood: Erythrocytes, leukocytes and thrombocytes
• What 3 categories can the causes of pancytopenia fall into?

  Decreased production

  Increased destruction or sequestration

  Peripheral dilution
• What are some conditions/causes that can lead to decreased production leading to pancytopenia?

  Marrow infiltration - leukaemia, lymphoma

  Aplastic anaemia

  Nutritional deficiencies
• What are some conditions/causes that can lead to increased destruction or sequestration leading to pancytopenia?

  Hypersplenism

  Paroxysmal nocturnal haemoglobinuria
• What are some conditions/causes that can lead to peripheral dilution leading to pancytopenia?

  Dilutional pancytopenia - Overhydration, transfusions
• What are some risk factors for pancytopenia?

  Drugs

  Toxins

  Radiation therapy

  Infections (HIV, Hep C)

  Autoimmune diseases
• How can pancytopenia be classified?

  Inherited

  Acquired

  Idiopathic
• What is the stereotypical presentation of pancytopenia?

  Generalised weakness

  Recurrent infections

  Abnormal bleeding or bruising
• How may a patient present with pancytopenia and why?

  Red cell deficiency (anaemia):

  • Pallor
  • Fatigue and weakness

  White cell deficiency (leukopenia):

  • Infections
  • Fever

  Platelet deficiency (thrombocytopenia):

  • Bleeding tendencies
• How is pancytopenia investigated?

  FBC

  Blood smear

  Bone marrow exam
• Why may some other tests be done for pancytopenia?

  Identify underlying cause
• How is pancytopenia managed?

  Treat underlying cause

  Supportive care

  Monitor for complications
• What are some complications of pancytopenia?

  Infections

  Bleeding

  Anaemia related complications