Pancytopenia Flashcards
what is pancytopenia?
deficiency of blood cells of all lineages
causes of pancytopenia
- reduced production
2. increased destruction
reduced production cause of pancytopenia
bone marrow failure
primary acquired causes of bone marrow failure
aplastic anaemia
MDS
acute leukaemia (proliferation of abnormal cells blocks HSC development)
secondary acquired causes of bone marrow failure
drugs
vitamin deficiency
infiltration= lymphoma, mets
miscellaneous
drug causes of bone marrow failure
chemotherapy alcohol azathioprine methotrexate chloramphenicol
vitamin deficiency causes of bone marrow failure
vitamin B12 and folate affect nuclear maturation of all lineages
miscellaneous causes of bone marrow failure
storage disorders
viral (HIV)
inherited cause of bone marrow failure
Fanconi’s anaemia
increased destruction cause of pancytopenia
hypersplenism
causes of hypersplenism
splenic congestion (portal hypertension)
RA
splenic lymphoma
presentation of pancytopenia
anaemia= fatigue, SOB neutropenia= gram -ve sepsis, fungal thrombocytopenia= bleeding
diagnosis of pancytopenia
FBC blood film B12/ folate LFTs virology, Ab bone marrow cytogenetics (chromosome fragility testing in Fanconi's anaemia)
management of pancytopenia
red cells, platelets
antibiotic prophylaxis
prompt treatment of neutropenic sepsis
what is Fanconi’s anaemia?
inability to correct strand cross-link damage in DNA
macrocytosis > thrombocytopenia > neutropenia (bone marrow failure and leukaemia risk)