16/02/2025
๐ Pancytopenia: Causes & Management Explained! ๐ฉธ๐ฉบ
Pancytopenia is a condition where all three blood cell lines (RBCs, WBCs, and platelets) are reduced. It can result from bone marrow failure, infiltration, or sequestration. Hereโs a breakdown of key causes and management strategies:
๐ฌ Causes of Pancytopenia
๐น Congenital: Fanconi anemia, Dyskeratosis congenita, Shwachman-Diamond syndrome
๐น Sequestration: Cirrhosis, Non-cirrhotic portal HTN, Feltyโs syndrome
๐น Bone Marrow Failure:
โข Nutritional: B12, Folate, Copper, Zinc toxicity, Alcohol, Malnutrition
โข Autoimmune: Aplastic anemia, PNH, SLE, Sarcoidosis
โข Infectious: Hepatitis, EBV, HIV, Parvovirus
โข Drugs/Toxins: Methimazole, PTU, Linezolid, Radiation, Benzene, Chloramphenicol
๐น Bone Marrow Infiltration:
โข Malignant: Leukemia, Lymphoma, Metastatic cancer, Myelodysplastic syndrome, Multiple myeloma
โข Non-Malignant: Tuberculosis, MAC, Brucellosis, Histoplasmosis, Storage disorders
โ๏ธ Management Approach
โ
Stabilization (ABC): Airway, Breathing, Circulation
โ
Transfusion: RBCs or platelets if needed
โ
Broad-Spectrum Antibiotics: If infection & neutropenia are present
๐ Clinical Findings to Watch For
๐ธ Petechiae, bruising, ecchymosis
๐ธ Blood blisters in the mouth (platelet dysfunction)
๐ธ Anemia (pallor, capillary refill delay)
๐ธ Splenomegaly & Sepsis
๐งช Essential Lab Tests
๐ฌ CBC + differential, reticulocyte count
๐ฌ Blood smear, nutrition levels (B12, folate, copper, iron)
๐ฌ Coagulation (PT, PTT, fibrinogen, DIC panel)
๐ฌ Infection screening (HIV, hepatitis, LFTs)
๐ฌ TSH/T4 (rarely the cause but easy to test)
๐ก Clinical Pearls
โจ Assess severity first (stabilize & transfuse if needed)
โจ Review time course & trends
โจ Get a blood smear for better diagnosis