Pancytopenia


Pancytopenia

Description, Causes and Risk Factors:

ICD9: 284.1.

Cytopenia is a reduction in the number of each type of peripheral blood cell. A reduction in all 3 types of cellular components in peripheral blood is termed pancytopenia and this involves anaemia, neutropenia, and thrombocytopenia. If RBCs are less then the condition is called anemia. In case of low white blood cell count, the condition is termed as leucopenia and if the platelets count is very low, then it is thrombocytopenia.

We can say a person is having pancytopenia if he has the following condition:

  • Absolute neutrophil count < 500/mm3.

  • Platelet count < 20,000/mm3

  • Corrected reticulocyte count < 1%.

According to some health experts, the basic cause for the occurrence of pancytopenia can be some bone marrow problem that affects the production of blood cells. Pancytopenia is commonly caused by Hepatitis B and C viruses, and rarely by Hepatitis A virus, cytomegalovirus, Epstein - Barr Virus, and HIV. Interestingly, 5% of adult aplastic anaemia and 1% of paediatric aplastic anaemia follow an episode of hepatitis. Hepatitis associated pancytopenia and hypoplastic anaemia has a high mortality rate of 89%.

Other rare causes are rubella, influenza, parainfluenza, measles, and mumps.

Drugs are the commonest, though quite often less well recognized, cause of pancytopenia. Their effects may be predictable or unpredictable. Genetics abnormalities also causes pancytopenia in certain cases. Exposure to radiation can also damage the bone marrow and cause the condition.

Risk Factors include

    Hodgkin and non-Hodgkin lymphoma, malignant melanoma, neuroblastoma and many more.

  • This medical condition can also affect people who are suffering from certain autoimmune diseases such as systemic lupus erythematosus.

  • Malignant osteoporosis.

  • Lymphohistiocytosis.

  • Dyskeratosis congenita.

  • Leishmaniasis.

Symptoms:

Common symptoms include

    Fatigue.

  • Rapid heart beat.

  • Shortness of breath (SOB).

  • Nose bleeding.

  • Increased menstrual bleeding.

  • Hemorrhage.

  • Petechiae.

  • Pallor.

Diagnosis:

The condition is generally diagnosed by a blood test to check any reduction in blood cell count. Essential tests include CBC, reticulocyte count, and ESR (erythrocyte sedimentation rate), alkaline phosphatase, serum protein electrophoresis, Anti-DNA, FANA (fluorescent antinuclear antibody), and urinary proteins.

Peripheral blood smear anisocytosis, poikilocytosis, neutrophil granules, neutrophilsegment, rouleaux formation, leukoerythroblastosis, and atypical cells.

Bone marrow biopsy.

Further investigation includes:

X-ray of the bone, chest, etc.

Treatment:

The treatment of pancytopenia is done by finding out the real cause of the symptoms. The treatment usually consists of medications. With proper medications and management, the blood count level goes up once again. Some patients may be given antibiotics prophylactically. Majority of patients are hospitalized until the symptoms are brought under control.

In pancytopenia, it is important to maintain the appropriate level of hemoglobin. Blood is given carefully so that circulatory overload can be avoided. Patients who are thrombocytopenic must not be given intramuscular injections and are not supposed to brush teeth. If there is active bleeding it is brought under control with infusion of platelet concentrates. Special attention is paid on prevention of infection. Maintenance of skin hygiene, excellent dental care and rectal hygiene are of great importance.

In rare cases, a bone marrow transplant may also be carried out. Patients are usually advised to take rest during their treatment for pancytopenia.

Disclaimer:The above information is general information (informational purpose only, sometimes may not be accurate). The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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