One approach that we discussed is to divide the causes of pancytopenia into those associated with bone marrow which is either hypocellular or hypercellular:
Hypocellular Marrow:
- Drugs/Toxins: Methotrexate, chemotherapeutics, various antibiotics, allopurinol...
- Infection: Parvovirus B19, EBV, HIV, TB, Hepatitis, Sepsis
- Autoimmune: Lupus, HLH
- Paroxysmal Nocturnal Hemoglobinuria (PNH)
- Malignancy: Leukemia, Lymphoma, MDS
- Nutritional: Deficiencies in B12, folate, copper
- Marrow Replacement: Myelofibrosis, Granulomatous disease (TB, sarcoid, fungal), solid tumor metastatic disease
This is a rare acquired stem cell disorder which can present as unexplained hemolytic anemia, thrombosis, hemoglobinuria and non-specific symptoms. It can certainly present as pancytopenia along with the associated complications. PNH should be considered in Coombs negative hemolytic anemia or other unexplained cases of anemia. The diagnosis is made with flow cytometry using a technique that determines whether certain cell wall proteins (GPI) are present or not - they are absent in PNH. Definitive treatment of PNH is a stem cell transplant.
Another few words about Myelophthisic Anemia:
What a great word! Whoever decided to put a `ph` next to a `th` must have enjoyed watching people struggle with pronouncing things... This entity was brought up today in morning report. Myelophthisis refers to bone marrow being displaced by some other process. This could include tumor, infection (TB), granulomatous conditions (sarcoid) or fibrosis. There are often clues on the peripheral blood film that may suggest a myelophthisic process. These include teardrop cells and nucleated red blood cells.
Check out this article for a general overview of the causes of pancytopenia: http://www.ncbi.nlm.nih.gov/pubmed/23270895
12 comments :
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what a miracle i never believe there is cure because my doctor tested me HSV 2 positive and she told me there is no cure, i’m very happy today that i’m having a free life without this sickness, i can remember some months ago when i was crying all through the night and day that i can’t get cured from this sickness, i found this herbal man email on internet when i was doing research on cure for HSV 2 i contacted him to found out if i can get help from this sickness, i was so surprise when he told me that he have the herbs cure to it and he sent me the herbal in less down 4 days i was so happy when i get someone giving me hope that he can cured me i took the herbal for just 2 weeks, when i went for test after taking the herbal i found out that i am cured i was so happy and surprise, i want to use this opportunity to inform you that there is cured to HSV 2 you can also contact him for his help as soon as possible so that you can get rid of this sickness once and for all you can reach him through this email: DRAZIEGBE1SPELLHOME@GMAIL. COM or and you can also call or whatapp him now +2349035465208. You can also contact him on any sickness in this he all have the herbal cure to it
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I have been suffering from (HERPES SIMPLEX VIRUS) disease for the past one years and had constant pain, especially in my knees. During the first year,I had faith in God that i would be healed someday.This disease started circulating all over my body and i have been taking treatment from my doctor, few weeks ago i came on search on the internet if i could get any information concerning the prevention of this disease, on my search i saw a testimony of someone who has been healed from (HERPES SIMPLEX VIRUS) by this Man Dr. USELU and she also gave the email address:(dr.uselucaregiver@gmail.com) of this man and advise we should contact him for any sickness that he would be of help, so i wrote to Dr. USELU telling him about my (HERPES Virus) he told me not to worry that i was going to be cured!! hmm i never believed it,, well after all the procedures and remedy given to me by this man few weeks later i started experiencing changes all over me as the doctor assured me that i have cured,after some time i went to my doctor to confirmed if i have be finally healed behold it was TRUE, So friends my advise is if you have such sickness or any other at all you can email::(dr.uselucaregiver@gmail.com) or whatsApp his number on (+2347052898482)
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