Pancytopenia

Clinical Manifestations

• Increased infections
• Bleeding
• Angina and other hypoxemic symptoms

Differential Diagnosis

• See also aplastic anemia
• Decreased production
  • Infection
    • Viral
      • Epstein-Barr virus: chronic active EBV and primary infection that results in hemophagocytic lymphohistiocytosis
      • Parvovirus B19: usually transient, but can also cause pure red cell aplasia
      • Cytomegalovirus, if immunocompromised
      • Hepatitis A virus
      • Human immunodeficiency virus
      • Dengue virus
    • Bacterial
      • Mycobacterium tuberculosis, in the context of disseminated disease
      • Leptospira species
      • Brucella species
      • Bartonella henselae and Bartonella quintana, causing bacillary angiomatosis involving liver and spleen
      • Mycoplasma pneumoniae, associated with fulminant infection and the presence of cold agglutinin disease
      • Ehrlichia chaffeensis, causing hemophagocytic lymphohistiocytosis
    • Fungal
      • Pneumocystis jirovecii, from bone marrow necrosis
    • Parasitic
      • Visceral leishmaniasis
  • Malignancy
    • Hematologic malignancy
    • Solid organ malignancy
      • Metastases
  • Other
    • Sarcoidosis
    • Amyloidosis
  • Systemic
    • Vitamin B12 deficiency
• Increased destruction
• Sequestration
• Drug-related
  • Linezolid
  • Coadministration of TMP-SMX and methotrexate