Lab

Pancytopenia

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Pancytopenia, Bicytopenia

  • See Also
  • Definition
  1. Bicytopenia: decrease in two of three cell lines
    1. May suggest Pancytopenia in development
  2. Pancytopenia: decrease in all blood cell lines
    1. Anemia
    2. Leukocytopenia
    3. Thrombocytopenia
  • Causes
  • Signs
  • Clinical Clues
  • Labs
  1. Complete Blood Count
    1. Pancytopenia consistent with cell counts as below
  2. Peripheral Smear
    1. Macrocytic Anemia
    2. Reticulocytopenia (Reticulocyte Index <1%)
    3. Thrombocytopenia (Platelet Count <20,000/mm3)
    4. Neutropenia
      1. Absolute Neutrophil Count <500/mm3
      2. ANC <200/mm3 suggests very severe disease
  • Evaluation
  1. Bone Marrow Biopsy: Normal count or hyperplasia
    1. Findings: Blasts, Dysplasia or Fibrosis
    2. Examples (See causes above)
      1. Myelodysplastic Syndrome
      2. Acute Myeloid Leukemia (AML)
      3. Agnogenic myeloid metaplasia
  2. Bone Marrow Biopsy: Fat infiltration (Hypoplasia)
    1. Acquired Aplastic Anemia or
    2. Fanconi's Anemia
      1. Diepoxybutane induced Chromosome breakage or
      2. Mitomycin-C induced Chromosome breakage
  • References
  1. Lee (1999) Wintrobe's Hematology, Lippincott, p. 1449
  2. Saiki in Friedman (1991) Medical Diagnosis, p. 225