Evaluation of pancytopenia

Last reviewed: 23 Jun 2024
Last updated: 12 Jul 2024

Summary

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

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.

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