Pancytopenia

Question 1

what are causes of pancytopenia?

Answer 1

PANCYTO
P: paroxysmal nocturnal haemaglobinuria
A: aplastic anaemia i.e. Fanconi’s, infection, immune disorder
N: neoplasm or near neoplasm i.e. leukaemia, myelodysplastic syndrome
C: consumption i.e. hypersplenism
Y: vitamin B12 deficiency
T: toxins i.e. drugs, alcohol, radiation
O: overwhelming infections i.e. sepsis, TB

Question 2

is a patient had pancytopenia with unknown cause, what investigations would you carry out?

Answer 2

FBC 
blood smear 
vitamin B12
HIV test 
paroxysmal nocturnal haemaglobinuria test 
viral serology 
bone marrow biopsy

Question 3

how would you manage a patient with pancytopenia?

Answer 3

treat by preventing complications associated with depletion of all cells lines;

• Red cell transfusion
• platelet transfusion
• infection prevention and treatment i.e. G-CSF, prophylactic antibiotics if neutrophil < 500, broad spectrum antibiotics if fever

Question 4

what are causes of aplastic anaemia?

Answer 4

fanconi's syndrome
drugs and toxins 
infections 
immune disorders
idiopathic