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Wednesday, May 16, 2012

Pancytopenia-Definition, Causes and Lab Diagnosis


Pancytopenia:

It is the simultaneous presence of anaemia, leucopenia and thrombocytopenia.

Pancytopenia exists in adults when all the following conditions are met:

                -The haemoglobin level is below 13.5 gm/dl in males or 11.5g/dl in females.
                -The leukocyte count is less than 4X109/L (<4000/mm3 of blood)
                -The platelet count is less than 150X109/L (<1.5 lac/mm3 of blood)

Causes of pancytopenia:

1. Aplastic anaemia

2. Subleukamic acute leukemia

3. Myelodisplastic disorders

4. Bone marrow infiltration and replacement:

-Hodgkin’s and Non-Hodgkin’s lymphoma
-Macroglobunaemia
-Multiple myeloma
-Metastatic carcinoma

5. Cytotoxic drugs

6. Radiotherapy

7. Systemic Lupus Erythematosus (SLE)

8. Paroxysmal nocturnal harmoglobinuria

9. Megaloblastic anaemia

10. Hypersplenism

Laboratory diagnosis of aplastic anaemia:

1. Routine haematological investigations:

                Haemoglobin-Reduced (5-7 g/dl)
                MCV elevated, MCH, MCHC are normal
                ESR- markedly high(150 mm or more in first hour)
                Peripheral blood film
                                RBC:Normocytic and normochromic with anisocytosis and poikilocytosis

2. Bone marrow investigations(Confirmatory):

                Cellularity: Hypocellular or acellur
                Myeloid : Erythorid ratio: Normal
                Erythropoiesis: Decreased
                Granulopoiesis-Decreased
                Megakaryopoiesis: Decreased
                Plasma cells-Increased
                Reticular cells-Increased
                Iron content-Increased

Reference : In the making of the above article the follwing books were used:



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