Evaluation of pancytopenia

Última revisão: 13 Sep 2025
Última atualização: 23 Jul 2025

Resumo

Differentials

Common

  • Chemotherapy
  • Radiation therapy
  • Vitamin B12 deficiency
  • Folic acid deficiency
  • Bone marrow infiltration by nonhematologic malignancy
  • Non-Hodgkin lymphoma
  • Hairy cell leukemia
  • Chronic lymphocytic leukemia
  • Myelodysplasia
  • Cirrhosis
  • Hepatitis B
  • Hepatitis C
  • Autoimmune hepatitis
  • HIV
  • Cytomegalovirus infection
  • Mycobacterial infection
Full details

Uncommon

  • Acute myeloid leukemia
  • Acute lymphoblastic leukemia (ALL)
  • Multiple myeloma
  • Myelofibrosis
  • Lysosomal storage disorders
  • Anorexia nervosa
  • Graft-versus-host disease (GVHD)
  • Heavy metal (arsenic) poisoning
  • Parvovirus infection in sickle cell anemia (and other hemolytic anemias)
  • Dyskeratosis congenita (DC)
  • Paroxysmal nocturnal hemoglobinuria (PNH)
  • Idiopathic aplastic anemia
  • Fanconi anemia
  • Other rare inherited cytopenias (e.g., Diamond Blackfan anemia, Shwachman Diamond syndrome, amegakaryocytic thrombocytopenia)
  • Idiopathic portal hypertension
  • Chronic myeloid leukemia
  • Brucellosis
  • Leishmaniasis
  • Hemophagocytosis syndromes
  • Drug-induced immune pancytopenia
  • Evans syndrome with associated neutropenia
  • Autoimmune lymphoproliferative syndrome (ALPS)
  • Systemic lupus erythematosus
  • Rheumatoid arthritis
  • Infectious mononucleosis
  • Felty syndrome
Full details

Contributors

Authors

Jeffrey M. Lipton, MD, PhD

Frances and Thomas Gambino Professor of Pediatrics in Hematology/Oncology

Professor of Pediatrics and Molecular Medicine

Donald and Barbara Zucker School of Medicine at Hofstra/Northwell

Professor, The Center for Autoimmune Musculoskeletal and Hematopoietic Diseases

Feinstein Institute for Medical Research

Director, Hematology/Oncology and Stem Cell Transplantation

Cohen Children's Medical Center of New York

Hyde Park

New York

Disclosures

JML has been reimbursed by Chiesi Farmaceutici S.p.A as a consultant.

Acknowledgements

Dr Jeffrey M. Lipton would like to gratefully acknowledge Dr Jeff K. Davies and Dr Eva C. Guinan, the previous contributors to this topic.

Disclosures

JKD and ECG declare that they have no competing interests.

Peer reviewers

Stella Davies, MD, PhD

Professor and Division Director

Cincinnati Children's Hospital Medical Center

Cincinnati

OH

Declarações

SD declares that she has no competing interests.

Drew Provan, BSc, MBChB

Consultant Hematologist

Department of Hematology

The Royal London Hospital

London

UK

Declarações

DP was medical director at GlaxoSmithKline 2005-2006.

Alfred P. Gillio, MD

Director

Bone Marrow Failure Clinic

Tomorrows Children's Institute

Hackensack University Medical Center

Hackensack

NJ

Declarações

APG declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

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Principais artigos

Kulasekararaj A, Cavenagh J, Dokal I, et al. Guidelines for the diagnosis and management of adult aplastic anaemia: a British Society for Haematology guideline. Br J Haematol. 2024 Mar;204(3):784-804.Texto completo  Resumo

Young NS. Aplastic anemia. N Engl J Med. 2018 Oct 25;379(17):1643-56.Texto completo  Resumo

Williams DA, Bennett C, Bertuch A, et al. Diagnosis and treatment of pediatric acquired aplastic anemia (AAA): an initial survey of the North American Pediatric Aplastic Anemia Consortium (NAPAAC). Pediatr Blood Cancer. 2014 May;61(5):869-74.Texto completo  Resumo

Khoury JD, Solary E, Abla O, et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: myeloid and histiocytic/dendritic neoplasms. Leukemia. 2022 Jul;36(7):1703-19.Texto completo  Resumo

Artigos de referência

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