Assessment of pancytopenia
Summary
Differentials
Common
- Chemotherapy
- Radiotherapy
- Vitamin B12 deficiency
- Folic acid deficiency
- Bone marrow infiltration by non-haematological malignancy
- Non-Hodgkin's lymphoma
- Hairy cell leukaemia
- Chronic lymphocytic leukaemia
- Myelodysplasia
- Cirrhosis
- Seronegative (idiopathic) hepatitis (likely autoimmune)
- Hepatitis B
- Hepatitis C
- Autoimmune hepatitis
- HIV
- Cytomegalovirus infection
- Mycobacterial infection
Uncommon
- Acute myeloid leukaemia
- Acute lymphocytic leukaemia (ALL)
- Multiple myeloma
- Myelofibrosis
- Lysosomal storage disorders
- Anorexia nervosa
- Graft-versus-host disease (GVHD)
- Heavy metal (arsenic) poisoning
- Parvovirus infection in sickle cell anaemia (and other haemolytic anaemias)
- Dyskeratosis congenita (DC)
- Paroxysmal nocturnal haemoglobinuria (PNH)
- Idiopathic aplastic anaemia
- Fanconi's anaemia
- Other rare inherited cytopenias (e.g., Diamond-Blackfan anaemia, Shwachman-Diamond syndrome, amegakaryocytic thrombocytopenia)
- Idiopathic portal hypertension
- Chronic myeloid leukaemia
- Brucellosis
- Leishmaniasis
- Haemophagocytosis syndromes
- Drug-induced immune pancytopenia
- Evans syndrome with associated neutropenia
- Autoimmune lymphoproliferative syndrome (ALPS)
- Systemic lupus erythematosus
- Rheumatoid arthritis
- Infectious mononucleosis
- Felty syndrome
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 declares that he has no competing interests.
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
Disclosures
SD declares that she has no competing interests.
Drew Provan, BSc, MBChB
Consultant Hematologist
Department of Hematology
The Royal London Hospital
London
UK
Disclosures
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
Disclosures
APG declares that he has no competing interests.
Guidelines
- Diagnosis and management of aplastic anaemia
- The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia
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