Pancytopenia

Pancytopenia is diagnosed by a full blood count showing the combination of: anaemia, thrombocytopenia, and leukopenia.

Causes of pancytopaenia

• Causes of decreased marrow haematopoetic function
  • Common causes include chemotherapy and radiotherapy (the pancytopenia may be transient).
  • Vitamin B12 and folate deficiency.
  • Marrow infiltration by haematological malignancies (leukaemias or lymphomas).
  • Myelofibrosis, in which there is progressive marrow fibrosis.
  • Multiple myeloma (a plasma cell dyscrasia).
  • Parvovirus infection in haemolytic disease (such as sickle cell anaemia).
• Inherited causes of marrow failure
  • The most common causes include Fanconi's anaemia (an autosomal recessive condition) and dyskeratosis congenita (an X-linked condition).
• Increased destruction/sequestration of blood cells peripherally
  • This is seen in conditions affecting the liver (such as hepatitis B/C, autoimmune hepatitis, and cirrhosis).
• Immune destruction of blood cells This occurs in drug-induced pancytopenia (secondary to, for example, Sulphonamide or Rifampicin).

Neutrophilia

Causes:

• Severe stress
  • Trauma
  • Surgery
  • Necrosis - necrosis also also causes release of IL-1 (causing pyrexia), the pyrexia and leucocytosis can be wrongly attributed to infection
  • Burns
  • Haemorrhage
  • Seizures
• Active inflammation
  • Polyarteritis nodosa
  • Myocardial infarction
  • Disseminated malignancy).
• Corticosteroid use (less common)
• Myeloproliferative disease like CML (less common)

Neutropenia

Causes:

• Severe sepsis
• Viral infection
• Drugs