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Journal articles on the topic 'Pancytopenie'

Author: Grafiati

Published: 4 June 2021

Last updated: 10 February 2022

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1

Polák, Pavel, Jan Kamelander, Jana Michalcová, Jiřina Zavřelová, Libor Červinek, Tomáš Rohan, Zuzana Pazdičová, Václav Odstrčilík, and Miroslav Penka. "Pancytopenia, panhypopituitarism and liver cirrhosis: analysis of a difficult clinical case." Vnitřní lékařství 65, no. 11 (November 1, 2019): 715–20. http://dx.doi.org/10.36290/vnl.2019.124.

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Polák, Pavel, Leoš Křen, Jana Lindušková, Andrea Pavlíková, Michael Doubek, Markéta Šejnohová, and Miroslav Penka. "Pancytopenia as the main manifestation of human immunodeficiency virus infection in the AIDS stage." Vnitřní lékařství 67, no. 4 (June 29, 2021): E26—E28. http://dx.doi.org/10.36290/vnl.2021.065.

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Raja, Shruti, Febe Renjitha Suman, Julius Xavier Scott, M. S. Latha, Aruna Rajenderan, and Ethican Abhirami. "Pancytopenia – (?) An obstacle in the diagnosis and outcome of pediatric acute lymphoblastic leukemia." South Asian Journal of Cancer 04, no. 02 (April 2015): 068–71. http://dx.doi.org/10.4103/2278-330x.155648.

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Abstract Context: Acute lymphoblastic leukemia (ALL) ranks first among pediatric malignancies. 8-12% of ALL present with pancytopenia and 2% with hypocellular marrow a. Diagnosis of ALL in the background of pancytopenia and aplastic bone marrow is difficult. Aims: This study was aimed to compare the clinicopathologic, genetic, and outcome of paediatric ALL patients with and without pancytopenia. Settings and Design: This is a retrospective cross-sectional study. Susbjects and Methods: The study included all ALL patients presenting with pancytopenia. The control group included equal number of randomly selected patients with ALL without pancytopenia treated during the same period. Ethics committee approved this study. The demographic, laboratory, and treatment-related details were retrieved from the records and entered in an Excel sheet. Statistical Analysis Used: Data was analyzed with Chi-square test with IBM SPSS statistics 16 software. Results: Diagnosis by peripheral smear is significantly lower (P = 0.015) in comparison with the control group. There is no significant difference in diagnosis between the groups by bone marrow aspirate (P = 0.731) and biopsy (P = 0.849). The diagnosis of leukemia is misdiagnosed as hypo cellular/aplastic marrow in 10% of the pancytopenic patients. Flow cytometry yielded the diagnosis in all the pancytopenic patients. Though cytogenetic abnormalities are more common in pancytopenic group, it is not statistically significant (P = 0.106). There is no significant difference in treatment outcome between the groups (P = 0.0827%). Conclusions: Clinical expertise is highly essential to evaluate a case of pancytopenia to diagnose leukemia. Pancytopenia is an obstacle in the diagnosis of ALL without immunophenotyping. There is no significant difference in the outcome between the two groups.

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Tazi Mezalek, Zoubida, Wafaa Ammouri, Mouna Maamar, Meriem Bourkia, Hicham Harmouche, Mohammed Adnaoui, Meryem Alaoui, and Nisrine Bouigua. "Vitamine B12 Deficiency Presenting As Severe Pancytopenia in Adult Patients. a Monocentric Study of 104 Cases." Blood 128, no. 22 (December 2, 2016): 4812. http://dx.doi.org/10.1182/blood.v128.22.4812.4812.

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Abstract Vitamin B12 deficiency should be suspected in all patients with unexplained anemia and/or neuropsychiatric symptoms, and special attention should be paid to patients at risk (the elderly, vegetarians, patients with autoimmune thyroiditis or vitiligo, patients receiving proton pump inhibitors or biguanides for prolonged periods). Documented symptomatic pancytopenia related to cobalamin deficiency is very rare representing less than 5% cases in different series. We aim to report an important series of pancytopenia related to cobalamin deficiency to analyze the clinical, biological and outcomes of those patients. Methods : Consecutive patients presented with B12 deficiency and pancytopenia were included. Charts were retrospectively reviewed from an internal medicine department during a period of 15 years (2000-2015). Diagnosis of cobalamine deficiency used the vitamin B12 dosage bellow 200 pg/ml. Assessment included clinical features, blood count and morphological review and a statistical analysis of those parameters comparing pancytopenic and non-pancytopenic patients. Results The medical records of 268 consecutive patients hospitalized for cobalamin deficiency from January 2000 to December 2015 were identified and retrospectively analyzed. Among them, 104 patients had pancytopenia (38.8%). The median age was 55+17 years and the sex ratio : 1. Pancytopenia revealed vitamin B12 deficiency in all cases. Neurological manifestations were associated in 13 cases and digestive involvement in 16 cases. Twenty five patients presented with febrile neutropenia. Fourteen patients (13.4%) presented with "pseudo" thrombotic microangiopathy. The mean hemoglobin level was 58+19 g/L, the neurtophils count was 1188+579/µl and median platelets count was 69.616+34.379/µl. Macrocytosis was present in 80.7% of patient with mean MCV was 106+11 fl, but was normal (<95 fl) in 20 patients. The mean serum vitamine B12 levels was 80+11 pg/ml. The median serum lactate dehydrogenase level was high (3.204 IU/L). The causes of B12 vitamin deficiency were mainly food cobalamin malabsorption (63.4%) and pernicious anemia (28.8%). Correction of the hematological abnormalities was achieved in all patients treated with either intramuscular, subcutaneous or oral cyanocobalamin. Significant differences appears comparing patients with or without pancytopenia. Pancytopenic patients had significantly lower MCV mean (p=0.001), lower polynuclear neutrophils count and lower platelets count. Atrophic gastritis was also significantly associated with pancytopenia (p=0.005). There was no significant difference in mean haemoglobin level (p=0.3), serum cobalamin level (p=0.17). Looking at other variables that could explain the high prevalence of pancytopenia in our series, there were no difference in ferritinemia level or number of patients with of iron deficiency . Conclusion In this study, based a single institution with a large number of consecutive patients with well-documented cobalamin deficiency, we found a high prevalence (38,8%) of severe pancytopenia. We don't find yet an explanation for those findings. Those results can also remind us that severe vitamin B12 deficiency may present with findings mimicking malign hematologic disorder and timely recognition and supplementation lead to resolution of symptoms and blood abnormalities. Disclosures No relevant conflicts of interest to declare.

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Mupamombe, Charles T., Felix M. Reyes, Derek B. Laskar, and Joseph Gorga. "Myxedema Coma Complicated by Pancytopenia." Case Reports in Medicine 2019 (July 14, 2019): 1–6. http://dx.doi.org/10.1155/2019/2320751.

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Hypothyroidism is common, with an extreme manifestation of myxedema coma if untreated. Hematologic consequences of myxedema coma include mild leukopenia and anemia, rarely pancytopenia. We present a patient with typical symptoms of myxedema coma, but found to be pancytopenic, with sustained response to levothyroxine and blood transfusion for anemia.

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Chikan, Nadia Shafi, Qazi Mohammad Iqbal, and Altaf Hussain Mir. "Clinico-haematological profile of adult pancytopenia patients at a tertiary care institute in South India." International Journal of Research in Medical Sciences 9, no. 2 (January 29, 2021): 521. http://dx.doi.org/10.18203/2320-6012.ijrms20210435.

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Background: Pancytopenia is not a disease by itself; rather it describes simultaneous presence of anemia, leukopenia and thrombocytopenia resulting from a number of disease processes. Varieties of hematological and non-hematological disorders may affect bone marrow either primarily or secondarily, resulting in the manifestation of pancytopenia. The incidence of various hematological disorders causing pancytopenia varies due to geographical distribution and genetic predisposition. This study highlights the spectrum of causes, clinical presentation and bone marrow morphology of pancytopenia.Methods: This prospective observational study was conducted for a period of two years at Al-Ameen Medical College, Bijapur, Bangalore. During this period, fifty patients with a hematological diagnosis of pancytopenia were studied during period in the department of pathology.Results: Among the 50 cases studied, 35 were males and 15 were females. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. Dimorphic anemia was predominant blood picture. Bone marrow study showed 72% hypercellular marrow, 12% normocellular and 16% hypocellular marrow. The commonest cause for pancytopenia was megaloblastic anemia followed by iron deficiency anaemia and malaria.Conclusions: The present study concludes that detailed hematological investigations along with bone marrow examination in pancytopenic patients is helpful to diagnose or rule out the causes of pancytopenia.

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Girardi, Angela Ferronato, Amanda Noéli da Silva Campos, Caroline Argenta Pescador, Arleana Do Bom Parto Ferreira de Almeida, Adriane Jorge Mendonça, Luciano Nakazato, Anderson Castro Soares de Oliveira, and Valeria Régia Franco Sousa. "Quantitative analysis of bone marrow in pancytopenic dogs." Semina: Ciências Agrárias 38, no. 6 (November 23, 2017): 3639. http://dx.doi.org/10.5433/1679-0359.2017v38n6p3639.

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The pancytopenia can be associated with intra and extra medullary disorders. When the etiology is not obvious, the examination of bone marrow is necessary. The study aims to report and discuss quantitative amendments in bone marrow and their causes in dogs with pancytopenia. Bone marrow aspirate was obtained from 65 dogs with pancytopenia over a period of 13 consecutive months for preparation of smears stained by Giemsa and observed in light microscopy. Five hundred cells differential count was held; and assessed myeloid:erythroid ratio, cellularity, megakaryocytes and direct parasitological examination. The data were evaluated by the Chi-square statistical test. Blood tests of 3120 canines with several clinical changes were analyzed to identify pancytopenia, which accounted for 167 (5.4%) dogs. Interpretation of quantitative characteristics was carried out from the bone marrow smear in 65 pancytopenic dogs and the etiology was established in 40 (61.5%) of these, which included infection by E. canis and L. chagasi, idiopathic aplastic anemia, chronic renal failure and co-infections. In 17 (26.2%) animals were not observed medullary changes. The most bone marrow change was observed myeloid and erythroid hypoplasia in 17 (26.2%) dogs, followed by myeloid and erythroid hyperplasia (24.6%). The myelogram association to the blood cell count allowed the identification of medullary findings and its participation on the occurrence of pancytopenia cases. The number of cases resulting from infectious diseases was 38 (58.5%) in canine assessed: significant number due to its endemic characteristic of the study region.

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Rahman, ATM Ataur, ARM Saifuddin Ekram, Mohammed Shahadat Hossain, Jayanta Kumar Saha, Fahreen Rahman, Muhammad Kamruzzaman, Ahmed Manadir Hossain, and MM Shahin Ul Islam. "Aetiology and Clinical Presentation of Pancytopenia in a Teaching Hospital." Faridpur Medical College Journal 13, no. 2 (October 20, 2019): 62–65. http://dx.doi.org/10.3329/fmcj.v13i2.43622.

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Pancytopenia is a morphological description of the peripheral blood picture irrespective of its cause & it denotes simultaneous presence of anaemia, leucopenia and thrombocytopenia. The study was done to observe the demographic profile & the clinical presentations of pancytopenic patients and to find out the aetiology of pancytopenia. This cross sectional study was carried out in Medicine ward of Rajshahi Medical College Hospital from August 2005 to July 2006. A uniform protocol was followed in all cases, to have appropriate history, physical findings & laboratory investigations. The commonest cause of pancytopenia was aplastic anaemia (48%) which was followed by hypersplenism (22%) & acute leukemia (16%). The majority cases of aplastic anaemia were idiopathic (57.69%), only 42.31% cases were due to secondary causes. The majority (94%) of patients was in the age range of 14-60 years and up to 54% was in the age group of 20-40 years. The ratio of male to female in patients of pancytopenia was 1.5:1 and 3:1 in aplastic anaemia. In secondary causes of aplastic anaemia, insecticides and viral hepatitis was found to be causative agent in 45.45% cases of each followed by pregnancy in 9.10% of cases. The common presenting complains of aplastic anaemia were generalized weakness (100%), gum bleeding (76.92%), fever (76.92%) and pallor (96.15%). Faridpur Med. Coll. J. Jul 2018;13(2): 62-65

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Chand, Ramesh, and Nutan Singh. "Clinic-etiological profile of pancytopenia in children: a tertiary care center based study of Kumaun region, India." International Journal of Contemporary Pediatrics 5, no. 6 (October 22, 2018): 2173. http://dx.doi.org/10.18203/2349-3291.ijcp20184275.

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Background: Pancytopenia is not a disease entity but a triad of findings in which all blood cell lineages i.e leukocytes, erythrocytes and platelets are reduced in blood .It is consequence of various medical conditions. Present study was conducted to assess the etiology, clinical profile and bone marrow morphology of pancytopenia.Methods: A cross sectional prospective study was carried out among 42 children of age between 1 to 15 year with pancytopenia. Blood samples of the patients were analyzed for complete blood count and peripheral smear along with presence and absence of immature cells and abnormal cells. In bone marrow examination, morphology of all cell’s lineage, cellularity, parasite and abnormal cells were scrutinized. Trephine biopsy was done if indicated. Special investigations were done to confirm the diagnosis.Results: Among the 42 cases studied, age of the patients ranged from 1 to 15 years with a slight male predominance. Most of the patients presented with generalized weakness and weight loss and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. The commonest cause for pancytopenia was megaloblastic anemia Among the non-haematological causes kala azar 5 (11.9%) is the leading cause in this study.Conclusions: The present study concludes that detailed primary haematological investigations along with bone marrow examination in pancytopenic patients are helpful for diagnosis and management. This study also suggests that megaloblastic anaemia, dimorphic anaemia and kala-azar should also be included in differential diagnosis of pancytopenia in this geographical area.

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Premkumar, M., N. Gupta, T. Singh, and T. Velpandian. "Cobalamin and Folic Acid Status in Relation to the Etiopathogenesis of Pancytopenia in Adults at a Tertiary Care Centre in North India." Anemia 2012 (2012): 1–12. http://dx.doi.org/10.1155/2012/707402.

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Background. Pancytopenia has multiple etiologies like megaloblastic anemia, aplastic anemia, leukemia, and various infections. We investigated the clinical, etiological and hematological profile including bone marrow morphology of patients with pancytopenia in relation to their vitamin B12 and folic acid status at a tertiary care referral hospital in north India.Methods. A total of 140 consecutive patients with pancytopenia were selected from June 2007 to December 2008. Bone marrow examination and other tests were carried out as warranted, including serum cobalamin and folate assays using liquid chromatography mass spectroscopy (LC MS/MS).Results. The study population consisted of 92 males and 48 females with a mean age of 32.8 years. Megaloblastic anemia 60.7%, aplastic anemia (7.8%), and leukemia (9.2%) were common causes. Infectious causes (16.4% of all cases) included leishmaniasis, HIV–AIDS, malaria and tuberculosis. Severe cobalamin deficiency (B12 < 100 pg/mL) was seen in 81% of all patients including 91.6% of patients with MA. In contrast, only 7.14% of all pancytopenic patients were folate deficient. Folate deficiency (<5 ng/mL) was seen in just 5% MA patients. Combined cobalamin and folate deficiency was seen in 5 patients (3.51%).Conclusion. Cobalamin deficiency was found to be more common in our setting and is largely underdiagnosed in the age of folate supplementation. Infectious diseases like tuberculosis, leishmaniasis, and increasingly HIV are important and treatable causes of pancytopenia. This is in contrast with the developed nations where the bulk of disease is due to malignancy or marrow aplasia.

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N., Gayathri B., and Kadam Satyanarayan Rao. "Pancytopenia: A Clinico Hematological Study." Journal of Laboratory Physicians 3, no. 01 (January 2011): 015–20. http://dx.doi.org/10.4103/0974-2727.78555.

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ABSTRACT Background: Pancytopenia is a relatively common hematological entity. It is a striking feature of many serious and life-threatening illnesses, ranging from simple drug-induced bone marrow hypoplasia, megaloblastic anemia to fatal bone marrow aplasias and leukemias. The severity of pancytopenia and the underlying pathology determine the management and prognosis. Thus, identification of the correct cause will help in implementing appropriate therapy. Objectives: To study the clinical presentations in pancytopenia due to various causes; and to evaluate hematological parameters, including bone marrow aspiration. Materials and Methods: It was a prospective study, and 104 pancytopenic patients were evaluated clinically, along with hematological parameters and bone marrow aspiration in Hematology Unit, Department of Pathology, JJMMC, Davanagere, during the period of September 2005 to September 2007. Results: Among 104 cases studied, age of patients ranged from 2 to 80 years with a mean age of 41 years, and male predominance. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. Dimorphic anemia was the predominant blood picture. Bone marrow aspiration was conclusive in all cases. The commonest marrow finding was hypercellularity with megaloblastic erythropoiesis. The commonest cause for pancytopenia was megaloblastic anemia (74.04%), followed by aplastic anemia (18.26%). Conclusion: The present study concludes that detailed primary hematological investigations along with bone marrow aspiration in cytopenic patients are helpful for understanding disease process and to diagnose or to rule out the causes of cytopenia. These are also helpful in planning further investigations and management.

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Shaikh, Nasreen, Muhammad Sardar, Rishi Raj, and Punit Jariwala. "A Rapidly Fatal Case of Low-Dose Methotrexate Toxicity." Case Reports in Medicine 2018 (June 13, 2018): 1–4. http://dx.doi.org/10.1155/2018/9056086.

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An 82-year-old female presented with multiple oral ulcers and malena for 1 week. Her laboratory tests revealed pancytopenia and acute renal failure. She had history of rheumatoid arthritis for which she was taking 7.5 mg methotrexate weekly and stage 4 chronic kidney disease from diabetic nephropathy. During the hospital stay, she developed pneumonia and septic shock requiring norepinephrine and vasopressin. She underwent continuous venovenous hemodiafiltration. Leucovorin, filgrastim, and multiple packed red blood cell and platelet transfusions were given. She remained hypotensive and pancytopenic despite all interventions. She died on day 6 of hospital stay from acute hypoxic respiratory failure due to septic shock.

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MYLONAKIS (Μ.Ε. ΜΥΛΩΝΑΚΗΣ), M. E., A. F. KOUTINAS (Α.Φ. ΚΟΥΤΙΝΑΣ), and D. KASABALIS (Δ. ΚΑΣΑΜΠΑΛΗΣ). "Diagnostic approach of canine Pancytopenia." Journal of the Hellenic Veterinary Medical Society 57, no. 1 (November 27, 2017): 69. http://dx.doi.org/10.12681/jhvms.15012.

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Canine pancytopenia in the peripheral blood is often the result of monocytic ehrlichiosis (Ehrlichia canis), parvoviral enteritis, sepsis and the use of various drugs (antineoplastic, nonsteroidal anti-inflammatory, antimicrobial, antiparasitic, antiepileptic, estrogens) accounting for bone marrow hypoplasiaaplasia. Sporadic cases of pancytopenia, induced by neoplastic myelophthisis, myelodysplastic and hemophagocytic syndromes, myelofibrosis, myelonecrosis and systemic lupus erythematosus may also be seen. A comprehensive diagnostic plan may include a detailed history (i.e. recent drug exposure), a thorough clinical examination, complete blood count, routine serum biochemistry and the microscopic examination of peripheral blood smears, to rule out false thrombocytopenia or leukopenia and to search for E canis morulae, leukemic cells and toxic neutrophilic changes. However, the diagnostic cornerstone in the pancytopenic dog is bone marrow cytology, for the undisputable differentiation between myelosuppressive and non-myelosuppressive monocytic ehrlichiosis and the confirmation of hemopoietic tumors, myelodysplastic or hemophagocytic syndromes and bone marrow aplasia. Bone marrow core biopsy and histopathology is the method of choice for the definitive diagnosis of myelofibrosis, myelonecrosis and occasionally of bone marrow aplasia. Also, serology for E canis and antinuclear antibodies and fecal ELISA for parvovirus antigen are strongly recommended, along with the application of various imaging techniques, especially for the detection of ovarian tumors.

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Chowdhury, Md Rezaul Karim, Md Haroon Ur Rashid, Amina Begum, Shamimur Rahman, and Md Momenuzzaman Khan. "Study on Diagnostic Evaluation of Pancytopenic Patients." Medicine Today 32, no. 1 (January 1, 2020): 58–61. http://dx.doi.org/10.3329/medtoday.v32i1.44834.

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Introduction: Pancytopenia is a common hematological problem with an extensive differential diagnosis and is a challenging problem to the treating physician. Bone marrow aspiration and biopsy is an important diagnostic test for patient management. The objective of this study is to find out the incidence various causes of pancytopenia in patients attending to the Enam medical college hospital in savar. Materials and Methods: This prospective observational study was done in the department of haematology, Enam Medical College Hospital (EMCH) from July 2012 to June 2019. Results: In our study out of 66 patients, 36 (54.55%) were male, 30 (45.45%) were female and male to female ratio were 1.2:1.Generalized weakness 47 (71.21%) and fever 23 (34.85%) were the most common presenting symptoms followed by bleeding 17 (25.76%), weight loss 6 (12.12%), bodyache 6 (9.09%). Most common clinical findings were anemia 57 (86.36%) and bone tenderness 22 (33.33%). Other physical findings were purpura/brusing 13 (19.70%), splenomegaly 10 (15.15%), lymphadenopathy 4 (6.06%) and hepatomegaly 3 (4.55%). Hematological malignancy 29 (43.94%) and hypoplastic marrow 26 (39.39%) were the most common bone marrow finding of pancytopenic patients followed by megaloblastic anaemia 4 (6.06%), leishmaniasias 5 (7.58), and erythroid hyperplasia 2 (3.03%). Acute myeloid leukaemia was the common haematological malignancy 16 (24.24%), others were acute lymphoblastic leukaemia 5 (7.58%). Myelodysplastic syndrome 3 (4.55%), multiple myeloma 4 (6.06%), chronic myelogenous leukaemia in blastic crisis 1 (1.52%). Conclusion: So we concluded that complete workup is essential for all cases of pancytopenia to find out the treatable cases and to reduce the motality and morbidity in serious diseases. Medicine Today 2020 Vol.32(1): 58-61

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Hassouna, Habiba, and Maha A. Assi. "Pancytopenia." Kansas Journal of Medicine 9, no. 2 (January 8, 2019): 37–39. http://dx.doi.org/10.17161/kjm.v9i2.8605.

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Hayat, Atif Sitwat, Abdul Haque Khan, Ghulam Hussian Baloch, and Naila Shaikh. "PANCYTOPENIA;." Professional Medical Journal 21, no. 01 (February 10, 2014): 060–65. http://dx.doi.org/10.29309/tpmj/2014.21.01.1790.

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Background: Pancytopenia is an important hematological problem encounteredin our day-to-day clinical practice. The aim of our study was to evaluate clinical features andetiological pattern of pancytopenia at tertiary care settings in Abbottabad. Methods: Thisprospective study was conducted at Northern Institue of Medical Sciences (NIMS) and AyubTeaching Hospital Abbottabad from 25th August 2009 to 31st July 2010. A total of 85 patientsfulfilling the criteria of pancytopenia were randomly selected by time-based sampling.Pancytopenia was diagnosed by anemia (hemoglobin ≤ 10.0g/dl), leucopenia (WBC ≤ 4.0×109/L)and thrombocytopenia (platelets ≤ 150×109/L). All data has been entered and analyzed by SPSSversion 10.0. Results: Out of 85 patients, 62(72.94%) were males and 23(27.05%) females withM to F ratio of 2.69:1. The mean age (±SD) of males was 30.20±15.42 years, while that of females35.12±16.31 years (p=0.20). Among clinical features, anemia and generalized weakness werethe commonest (97.64%), followed by shortness of breath (88.23%). Majority 54(63.52%) hadnon-malignant disorders responsible for pancytopenia. Overall, the most common cause ofpancytopenia was aplastic anemia noted in 30(35.29%) cases, followed by megaloblastic anemia15(17.64%) and hypersplenism in 13(15.29%). Conclusions: On conclusion, aplastic anemiawas the most common cause of pancytopenia in our study predominantly affecting young adultmales. It

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JALBANI, AZIZULLAH, Kouro Mai Gurbakhs, IMDAD ALI ANSARI, Mumtaz Chutto, AFTAB HUSSAIN SHAH, and Ghulam Akbar Solangi. "PANCYTOPENIA." Professional Medical Journal 17, no. 01 (March 10, 2010): 105–10. http://dx.doi.org/10.29309/tpmj/2010.17.01.2081.

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Introduction: Pancytopenia is said to exist in an adult when the hemoglobin level is less than 13.5gm/dl in males and 1 l.5gm/dlin females, white cell count less than 4xl09IL and platelet count less than 150x109/L1. The causes of pancytopenia are aplastic anemia, subleukemicleukemia, myelodysplasia2 multiple myeloma, nutritional deficiencies leading to megaloblastic anemia, hypersplenism, paroxysmalnocturnal hemoglobinuria, AIDS, infections such as miliary tuberculosis, leishmaniasis, brucellosis etc. Objectives: To determine the frequencyof various causes of pancytopenia in gender at Chandka Medical College, Larkana. Study design: Cross Sectional Study. Setting: OPD &Medical Ward-ll, Chandka Medical College Hospital Larkana. Duration with dates: 01 years study from February 2007 to February 2008.Subject and methods: Patients of either sex, who attended medical ward-ll of Chandka Medical College Hospital Larkana, either as inpatientor out patient department, from February 2007 to February 2008 and fulfilled the inclusion criteria, were included in this study. Pancytopeniawas considered as hemoglobin value less than 13.5gm/dl in males or 11.5gm/dl in females, a white cell count less than 4x109/L and Plateletscount less than 150x109/L. Patients of less than 12 years and pregnant females were excluded from the study. Result: Out of 40 patients, 29(72.5%) were males and 11 (27.5%) were females. Female to male ratio was 1:2.6. The mean ages of males were 29.10 ± 16.46 years whereasof females 36.14 ± 15.6 years (P = 0.22). Aplastic anemia was the most common pathology encountered and was diagnosed in 13 cases(31.5%), followed by hypersplenism 09 (22.9%), Megaloblastic anemia 06 (15%) and hodgkin's lymphoma in 04 (10%) cases. Other lesscommon causes detected were multiple myeloma 02 (5%), drug induced 02 (5%) and malaria, milliary tuberculosis, myelodysplastic syndrome,hemophagocytic syndrome was 01 (2.5%) case in each. Conclusion: We concluded that aplastic anemia was the most common cause in ourpatients and more than 2/3rd patients were young males. We think the causes of aplastic anemia in this study may be misuse of drugs, kushtas,exposure to chemicals and viral infections.

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Sabita, Palai, Swain Santosh Kumar, Nayak Rajeeb Kumar, Majhi Majha, Padhi Prabhat Kumar, and Behera Manoranjan. "A prospective clinico-etiological study of 100 cases of pancytopenia in a tertiary care hospital in Eastern India." Panacea Journal of Medical Sciences 11, no. 2 (August 15, 2021): 236–40. http://dx.doi.org/10.18231/j.pjms.2021.049.

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Pancytopenia is a hematological entity which is relatively common. Its evaluation is important for arriving at an early and correct diagnosis, to aid in appropriate management.It was an observational study conducted in the Department of General Medicine and Clinical Hematology of our institute from June 2019 to May 2020. Clinical, hematological and biochemical parameters of 100 pancytopenic patients were evaluated and descriptive statistics was used. The age ranged from 18-75 years. The commonest presentation was easy fatigability and fever. Besides pallor, splenomegaly and hepatomegaly were the presenting signs. Megaloblastic anaemia was detected in 64% followed by aplastic anaemia in 12% and acute leukemia in 6% patients. Among infective etiologies, two cases of malaria (P. falciparum). And each case of HIV, tuberculosis and dengue were seen. Lowest Hb% of 1.8 gm/dl, lowest total leucocyte count (TLC) of 500cells/cmm and lowest total platelet count (TPC) of 4000 cells/cmm was noted in a case of aplastic anemia. Macrocytic anemia was predominant blood picture. Hypercellular marrow was noted in 70(70%) cases and common cause was megaloblastic anemia, followed by leukaemia. Hypocellular marrow was noted in 12(12%) patients with aplastic anemia being commonest cause. In our study diagnosis of pancytopenia and its causes were ascertained by hematological investigations. An early and prompt treatment was given according to the cause and severity. Most of the cases had good prognosis due to a treatable cause.

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Mobin, Ahsan, Imtiaz Manzoor, Hafeezullah Shaikh, and Muhammad Ashraf Ebrahim. "CHRONIC LIVER DISEASE." Professional Medical Journal 25, no. 02 (February 3, 2018): 292–96. http://dx.doi.org/10.29309/tpmj/18.4227.

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Lakhani, Nita, William Thompson, and Anne Marie Bombassaro. "Probable Linezolid-Induced Pancytopenia." Canadian Journal of Infectious Diseases and Medical Microbiology 16, no. 5 (2005): 286–88. http://dx.doi.org/10.1155/2005/961613.

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A 75-year-old male outpatient with cardiac disease, diabetes, chronic renal insufficiency and iron deficiency anemia was prescribed linezolid 600 mg twice daily for a methicillin-resistant Staphylococcus aureus diabetic foot osteomyelitis. After one week, his blood counts were consistent with baseline values. The patient failed to return for subsequent blood work. On day 26, he was admitted to hospital with acute renal failure secondary to dehydration, and was found to be pancytopenic (erythrocytes 2.5x1012/L, leukocytes 2.9x109/L, platelets 59x109/L, hemoglobin 71 g/L). The patient was transfused, and linezolid was discontinued. His blood counts improved over the week and remained at baseline two months later. The patient's decline in blood counts from baseline levels met previously established criteria for clinical significance. Application of the Naranjo scale indicated a probable relationship between pancytopenia and linezolid. Clinicians should be aware of this rare effect with linezolid, and prospectively identify patients at risk and emphasize weekly hematological monitoring.

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Reshma, Samira Taufique, Susane Giti, Shahed Ahmed Chowdhury, Mohammad Golam Rabbani, Mohammad Iqbal Kabir, and Md Atiqul Islam Rabby. "Clinico-Haematological Study of Pancytopenia." Medicine Today 33, no. 1 (February 25, 2021): 12–18. http://dx.doi.org/10.3329/medtoday.v33i01.52151.

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Introduction: Pancytopenia is a clinical condition, which refers to a combination of anaemia, leucopenia and thrombocytopenia. It often poses diagnostic challenge to physician and the knowledge of accurate etiologies of this condition is crucial in the management of the patient. Materials and Methods: The study was a prospective study done over a period of October 2011 to December 2011 and 50 patients were evaluated clinically along with haematological parameters, bone marrow aspiration and wherever required, a trephine biopsy was performed in Haematology department of Armed forces institute of pathology (AFIP), Dhaka cantonment, Dhaka. In all patients, a detailed relevant history along with a physical examination was done and data was collected using pre designed proforma. Results: Among the 50 cases studied, age of the patients ranged from 3 to 80 yrs with a mean age of 37.5 yrs and male predominance. Fever and generalized weakness were the most common symptoms. The commonest physical findings were pallor followed by splenomegaly and hepatomegaly. Anisopoikilocytosis and relative lymphocytosis was the most prominent peripheral blood findings in patients. The commonest cause of pancytopenia was Aplastic anaemia (36%), followed by Myelodysplastic syndrome (18%), visceral leishmaniasis (12%), Megaloblastic anaemia (8%), Acute leukaemia (6%), Myelofibrosis (4%), Multiple myeloma (4%), Hypersplenism (4%), Malaria (2%). Conclusion: As a large number of pancytopenic patients have a reversible aetiology, early & proper diagnosis may be life saving. Maximum diagnostic yield can be achieved by correlation with clinical findings & laboratory parameters. Medicine Today 2021 Vol.33(1): 12-18

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22

Keisu, M., W. Heit, G. Lambertenghi-Deliliers, J. Parcells-Kelly, A. Polliack, and H. Heimpel. "Transient pancytopenia." Blut 61, no. 4 (October 1990): 240–44. http://dx.doi.org/10.1007/bf01744138.

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23

P.U., Dipin Kumar. "Clinicopathological Correlation of Pancytopenia." Indian Journal of Emergency Medicine 2, no. 2 (2016): 101–4. http://dx.doi.org/10.21088/ijem.2395.311x.2216.2.

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Gibbs, Simon D., David Alan Westerman, John Francis Seymour, and Miles Prince. "Prolonged Severe Pancytopenia and Myelodysplastic Features Following Alemtuzumab Therapy in Patients with Cutaneous T-Cell Lymphomas." Blood 104, no. 11 (November 16, 2004): 2645. http://dx.doi.org/10.1182/blood.v104.11.2645.2645.

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Abstract Background. Alemtuzumab is an increasingly utilized salvage therapy for refractory and/or relapsed B- and T-cell lymphoproliferative disorders with response rates of ~35%. Therapy has been associated with significant infectious and haematologic toxicity. Multilineage cytopenias are a recognised complication, but have been described mostly among patients with CLL and are transient. We report four of twelve (33%) patients treated with alemtuzumab for T-cell lymphoproliferative disorders with unexpectedly prolonged multilineage cytopenias (4 - 11+ months) including two cases of marrow aplasia and one of definitive clonal myelodysplasia. Methods. Patients received the standard alemtuzumab schedule (Eur J Haematol71:250, 2003) of one dose of 3mg IV on d1,10mg on d3 and 30mg on d5, then 30 mg thrice weekly for 12 weeks. Cytomegalovirus (CMV) PCR was performed in all cases of fever, or pancytopenia. Haematologic toxicity was graded according to the NCI Common Toxicity Criteria. Results. 11 patients with advanced (IIB-IV) relapsed and/or refractory cutaneous T-cell lymphomas and one with T-cell PLL were treated. The median age was 55 years (range 29 – 69) and the median number of previous treatments was 4 (range 0 – 17). The median cumulative dose of alemtuzumab was 333mg (range 98–1056). Five patients (42%) experienced grade IV (<0.5 x 109/L) neutropenia and thrombocytopenia (<25 x 109/L). In 4 cases this severity of cytopenias lasted > 2 months, some never recovering before their death, or with persisting cytopenias during follow-up. The fifth patient died five weeks after starting alemtuzumab with pancytopenia and progressive disease. Four had confirmed CMV reactivation. Neutropenia occurred within 2 weeks of reactivation and in 2 patients, pancytopenia occurred before ganciclovir commenced. One patient who did not experience prolonged pancytopenia had CMV reactivation. One had evidence of chronic parvovirus P19 infection and none had evidence of haemophagocytosis. Discussion. In our series, the alemtuzumab-associated cytopenias were more prolonged than previously described. In four patients, recovery occurred well after the expected two weeks. Two had evidence of marrow aplasia, one of whom died soon after this diagnosis; the other is alive, remaining pancytopenic and transfusion dependent at 14+ weeks after treatment. A third patient was diagnosed with myelodysplasia (cytogenetics: 45X, Y(8)/46, XY (12)), never recovering normal counts, now 12 months post treatment. There was no difference in the liklihood of developing cytopenias in terms of age, sex or dose of alemtuzumab and the pancytopenia never heralded disease recurrence. The exact mechanism of alemtuzumab-associated haematologic toxicity remains elusive. While prolonged lymphopenia is expected, pancytopenia is unexpected since neither haematopoietic stem cells (CD34+) nor more mature myeloid or erythroid cells or megakaryocytes express CD52. We believe the prolonged cytopenias observed were partially a direct effect of alemtuzumab as we excluded infective causes such as parvovirus P19 in four of the five patients and haemophagocytosis in all. Whether the CMV reactivation is involved in the development of, or prolongs the duration of the cytopenias is unknown and further study into the link between CMV and alemtuzumab in the advent of cytopenias in T-cell lymphoproliferative disorders is warranted.

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25

Bharath, C. "Pancytopenia-An Evaluation." IOSR Journal of Dental and Medical Sciences 8, no. 5 (2013): 42–45. http://dx.doi.org/10.9790/0853-0854245.

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26

Mudenge, Boniface, David G. Savage, Robert H. Allen, Innocent T. Gangaidzo, Lorraine M. Levy, Christine Gwanzura, Alpha Moyo, et al. "Pancytopenia in Zimbabwe." American Journal of the Medical Sciences 317, no. 1 (January 1999): 22–32. http://dx.doi.org/10.1016/s0002-9629(15)40466-5.

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27

Elouni, Bouraoui, Chaker Ben Salem, and Michel Biour. "Levetiracetam-Induced Pancytopenia." Annals of Pharmacotherapy 43, no. 5 (May 2009): 985. http://dx.doi.org/10.1345/aph.1l727.

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28

Davis, H., and D. Boothe. "Pancytopenia in horses." Equine Veterinary Education 27, no. 10 (September 23, 2015): 524. http://dx.doi.org/10.1111/eve.12457.

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29

Shields, Anthony F., and Jeffrey A. Berenson. "Procainamide-associated pancytopenia." American Journal of Hematology 27, no. 4 (April 1988): 299–301. http://dx.doi.org/10.1002/ajh.2830270413.

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30

Lyonnais, Jean. "Thymoma and pancytopenia." American Journal of Hematology 28, no. 3 (July 1988): 195–96. http://dx.doi.org/10.1002/ajh.2830280314.

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31

Angel, A. Gonz�lez-del, M. Cervera, L. G�mez, P. P�rez-Vera, L. Orozco, A. Carnevale, and V. Del Castillo. "Ataxia-pancytopenia syndrome." American Journal of Medical Genetics 90, no. 3 (January 31, 2000): 252–54. http://dx.doi.org/10.1002/(sici)1096-8628(20000131)90:3<252::aid-ajmg14>3.0.co;2-v.

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32

WILLOCKS, LORNA, and RAY BRETTLE. "Foscarnet and pancytopenia." Journal of Antimicrobial Chemotherapy 29, no. 2 (1992): 232. http://dx.doi.org/10.1093/jac/29.2.232.

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33

Gonzalez-Ibarra, Fernando, Sahar Eivaz-Mohammadi, Shiri Surapaneni, Hazem Alsaadi, Amer K. Syed, Simon Badin, Valentin Marian, and Mazhar Elamir. "Methotrexate Induced Pancytopenia." Case Reports in Rheumatology 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/679580.

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The well-reported methotrexate (MTX) toxicities are based on the duration and cumulative dosing of drug. The typical toxicities can be predicted by the timing of drug administration, where mucositis occurs as an earlier effect, while myelosuppression and the sequelae of pancytopenia occur later after MTX administration. Despite these well-known toxicities, low dose MTX therapy can become problematic, in particular with the elderly, who are at a greater risk for significant myelosuppression. We present a case of a 73-year-old female with pancytopenia causing severe neutropenia, mucocutaneous bleeding, and bruising and requiring intravenous antibiotic therapy and limited transfusion dependence as a result of low dose daily MTX for rheumatoid arthritis.

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34

Epstein, M., A. D. Pearson, S. J. Hudson, R. Bray, M. Taylor, and J. Beesley. "Necrobacillosis with pancytopenia." Archives of Disease in Childhood 67, no. 7 (July 1, 1992): 958–59. http://dx.doi.org/10.1136/adc.67.7.958.

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35

Carroll, William L., F. Ralph Berberich, and Bertil E. Glader. "Pancytopenia with Myelofibrosis." Clinical Pediatrics 25, no. 2 (February 1986): 106–8. http://dx.doi.org/10.1177/000992288602500210.

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36

Irvine, A. E., A. N. Agnew, and T. C. Morris. "Amoxycillin induced pancytopenia." BMJ 290, no. 6473 (March 30, 1985): 968–69. http://dx.doi.org/10.1136/bmj.290.6473.968.

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37

Halpern, Michele. "Linezolid‐Induced Pancytopenia." Clinical Infectious Diseases 35, no. 3 (August 2002): 347–48. http://dx.doi.org/10.1086/341309.

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38

Hsia, Cyrus C., and Alejandro Lazo-Langner. "Histoplasmosis-induced pancytopenia." Blood 120, no. 15 (October 11, 2012): 2937. http://dx.doi.org/10.1182/blood-2012-03-417782.

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39

Narang, Vikram, and Man Updesh Singh Sachdeva. "Posttransplantation and pancytopenia." Blood 120, no. 19 (November 8, 2012): 3872. http://dx.doi.org/10.1182/blood-2012-06-433003.

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40

SAVAGE, DAVID G., ROBERT H. ALLEN, INNOCENT T. GANGAIDZO, LORRAINE M. LEVY, CHRISTINE GWANZURA, ALPHA MOYO, BONIFACE MUDENGE, et al. "Pancytopenia in Zimbabwe." American Journal of the Medical Sciences 317, no. 1 (January 1999): 22–32. http://dx.doi.org/10.1097/00000441-199901000-00004.

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41

Alzahrani, Talal, Dana Kay, Saeed A. Alqahtani, Yamane Makke, Linda Lesky, and Mohamad Z. Koubeissi. "Levetiracetam-induced pancytopenia." Epilepsy & Behavior Case Reports 4 (2015): 45–47. http://dx.doi.org/10.1016/j.ebcr.2015.06.001.

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42

Uyttenbroeck, Wim, Marcel Korthout, Robrecht Bock, Dirk R. Bockstaele, and Marc E. Peetermans. "Cimetidine induced pancytopenia." Blut 60, no. 6 (June 1990): 323–27. http://dx.doi.org/10.1007/bf01737845.

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43

Bader-Meunier, B., A. Dusser, J. M. Mersh, P. Landrieu, E. Dussaix, and G. Tchernia. "Varicella-associated pancytopenia." European Journal of Pediatrics 149, no. 11 (August 1990): 810–11. http://dx.doi.org/10.1007/bf01957291.

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44

Rehmani, Tariq Hameed Rehmani, Mizna Arif, Sajjad Heraid, Sarah Arif, Rabia Ahmad, and Muhammad Saeed. "SPECTRUM OF PANCYTOPENIA." Professional Medical Journal 23, no. 05 (May 10, 2016): 620–26. http://dx.doi.org/10.29309/tpmj/2016.23.05.1594.

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Pancytopenia refers to a reduction in all the three cellular elements of blood.Pancytopenia is a common but important hematological problem encountered in routineclinical Practice. It may be a presenting feature of many underlying serious and life threateningillnesses. Objective: Present study was planned to appraise various clinico- etiologicalfactors underlining Pancytopenia. Study Design: Cross-sectional study. Setting: HematologyDepartment of Allama Iqbal Medical College/ Jinnah Hospital Lahore (AIMC&JHL). Period:July 2011 to Jun 2015. Materials and Methods: Two hundred and forty four patients withPancytopenia were included in the study. Complete blood count, bone marrow aspirations andtrephine biopsies were performed after clinical history and physical exam. Data were analyzedby using SPSS 20.0 version. Results: Out of total 244 Pancytopenia cases, hypoplastic bonemarrow 66 (27.04%) and Megaloblastic anemia 49 (20.08%) were the most common etiologicalfactors with male predominance. Fever and pallor were striking presenting clinical features.Conclusion: We conclude that Pancytopenia is a common problem with an exhaustive listof differential diagnosis, some of which are easily treatable and reversible. Therefore earlydetection with optimal diagnostic approach to Pancytopenia is required for better managementof patients.

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TARIQ, MOHAMMAD, RABIA BASRI, NAJI ULLAH KHAN, and Said Amin. "AETIOLOGY OF PANCYTOPENIA." Professional Medical Journal 17, no. 02 (June 10, 2010): 252–56. http://dx.doi.org/10.29309/tpmj/2010.17.02.2371.

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Background: Pancytopenia is a reduction in the number of each type of peripheral blood cell. Therefore the role of bone marrow examintion in diagnosis of pancytopenia is important to know etiology of pancytopenia. The objective of the study was to know the aetiology of pancytopenia. Methods: This descriptive (Cross sectional) study was carried out in Khyber teaching hospital. Fifty patients with pancytopenia were included in the study from 1st January 2008 to 30th October 2008. Full blood counts, bone marrow examinations and trephine biopsies were performed according to standard methods. Statistical packages for social science (SPSS.11) was used to analyze data. Results: Out of 50 patients, 36% were of aplastic anaemia, 16% megaloblastic anaemia, 14% myelodysplastic syndrome and 12% acute lymphoblastic leukemia (ALL), Hypersplenism in 10%, 4% non Hodgkin lymphoma (NHL) and 4% multiple myeloma, 2% each of acute myeloblastic leukemia and chronic myelocytic leukemia. All of these disorders were common in male as compared to female. Conclusions: Aplastic anaemia was the commonest cause of pancytopenia followed by megaloblastic anemia and myelodysplastic syndrome in our study.

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Robledo, Raymond F., Steven L. Ciciotte, Joel H. Graber, Yue Zhao, Amy J. Lambert, Babette Gwynn, Nathaniel J. Maki, et al. "Differential effects of RASA3 mutations on hematopoiesis are profoundly influenced by genetic background and molecular variant." PLOS Genetics 16, no. 12 (December 28, 2020): e1008857. http://dx.doi.org/10.1371/journal.pgen.1008857.

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Studies of the severely pancytopenic scat mouse model first demonstrated the crucial role of RASA3, a dual RAS and RAP GTPase activating protein (GAP), in hematopoiesis. RASA3 is required for survival in utero; germline deletion is lethal at E12.5–13.5 due to severe hemorrhage. Here, conditional deletion in hematopoietic stem and progenitor cells (HSPCs) using Vav-iCre recapitulates the null phenotype demonstrating that RASA3 is required at the stem and progenitor level to maintain blood vessel development and integrity and effective blood production. In adults, bone marrow blood cell production and spleen stress erythropoiesis are suppressed significantly upon induction of RASA3 deficiency, leading to pancytopenia and death within two weeks. Notably, RASA3 missense mutations in two mouse models, scat (G125V) and hlb381 (H794L), show dramatically different hematopoietic consequences specific to both genetic background and molecular variant. The mutation effect is mediated at least in part by differential effects on RAS and RAP activation. In addition, we show that the role of RASA3 is conserved during human terminal erythropoiesis, highlighting a potential function for the RASA3-RAS axis in disordered erythropoiesis in humans. Finally, global transcriptomic studies in scat suggest potential targets to ameliorate disease progression.

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Gonzaga, Vivian Fonseca, Cristiane Valverde Wenceslau, Gustavo Sabino Lisboa, Eduardo Osório Frare, and Irina Kerkis. "Mesenchymal Stem Cell Benefits Observed in Bone Marrow Failure and Acquired Aplastic Anemia." Stem Cells International 2017 (2017): 1–12. http://dx.doi.org/10.1155/2017/8076529.

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Acquired aplastic anemia (AA) is a type of bone marrow failure (BMF) syndrome characterized by partial or total bone marrow (BM) destruction resulting in peripheral blood (PB) pancytopenia, which is the reduction in the number of red blood cells (RBC) and white blood cells (WBC), as well as platelets (PLT). The first-line treatment option of AA is given by hematopoietic stem cell (HSCs) transplant and/or immunosuppressive (IS) drug administration. Some patients did not respond to the treatment and remain pancytopenic following IS drugs. The studies are in progress to test the efficacy of adoptive cellular therapies as mesenchymal stem cells (MSCs), which confer low immunogenicity and are reliable allogeneic transplants in refractory severe aplastic anemia (SAA) cases. Moreover, bone marrow stromal cells (BMSC) constitute an essential component of the hematopoietic niche, responsible for stimulating and enhancing the proliferation of HSCs by secreting regulatory molecules and cytokines, providing stimulus to natural BM microenvironment for hematopoiesis. This review summarizes scientific evidences of the hematopoiesis improvements after MSC transplant, observed in acquired AA/BMF animal models as well as in patients with acquired AA. Additionally, we discuss the direct and indirect contribution of MSCs to the pathogenesis of acquired AA.

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Prasad, Dr Haridas B., Dr Sachin Sarode, and Dr Dilip B. .Kadam. "Clinical Profile of Pancytopenia in Adults." International Journal of Scientific Research 2, no. 7 (June 1, 2012): 355–57. http://dx.doi.org/10.15373/22778179/july2013/121.

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49

Para, Rajesh, and Shailaja Para. "Pancytopenia: A Tertiary Care Institutional Study." Indian Journal of Forensic Medicine and Pathology 10, no. 2 (2017): 59–62. http://dx.doi.org/10.21088/ijfmp.0974.3383.10217.11.

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Mathapati, Sangamesh, Aruna Biradar, Laxmi Sangolli, Gamini BS, and Sridevi HS. "Pancytopenia in pregnancy: a case series." New Indian Journal of OBGYN 7, no. 2 (January 2021): 241–44. http://dx.doi.org/10.21276/obgyn.2021.7.2.26.

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