Question
Differential diagnosis of pancytopenia.
Q104 marksShort Answers
Answer
Pancytopenia is the reduction of all three peripheral blood cell lines — red cells, white cells, and platelets — below normal.
Causes of decreased marrow production
- Aplastic anaemia (idiopathic, drug-induced, radiation, viral)
- Megaloblastic anaemia (vitamin B12/folate deficiency)
- Marrow infiltration — leukaemia, lymphoma, multiple myeloma, metastatic carcinoma (myelophthisis)
- Myelodysplastic syndrome
- Paroxysmal nocturnal haemoglobinuria
Causes of increased peripheral destruction/sequestration
- Hypersplenism (splenic sequestration — e.g., portal hypertension, malaria, kala-azar)
- Systemic lupus erythematosus (autoimmune)
Others
- Severe sepsis/disseminated intravascular coagulation
- HIV infection
- Chemotherapy/radiotherapy effect
- 1Acute Leukaemia
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