(A&E)

Overview

• Decrease in the number of RBC’s, WBC’s and platelets in the peripheral blood flow
• May be due to decreased bone marrow cell production or bone marrow failure, clonal disorders of haematopoiesis, increased non-immune-mediated destruction or sequestration, or an immune-mediated destruction of blood cells
• Causes:
  • Aplastic Anaemia → type of anaemia caused by bone marrow failure
    • Normochromic, normocytic anaemia
    • Leads to decrease of all cells (pancytopenia) ⇒ ie. leukopenia, anaemia, thrombocytopaenia
  • Myelofibrosis
  • Multiple Myeloma → malignancy characterised by plasma cell proliferation
  • Methotrexate → can lead to bone marrow suppression hence causing pancytopenia
  • Acute & Chronic Leukaemia
  • Chemotherapy + Radiotherapy
  • B12 or Folate Deficiency
  • Lymphoma

Making Diagnosis

Clinical Features:

• Symptoms of anaemia/leukopenia/thrombocytopenia → SOB, pale skin, fatigue, weakness, fever, easy bruising, petechiae, purpura, bleeding gums and nosebleeds, recurrent infections

Investigations:

• FBC and Blood Smear
• Bone Marrow Aspiration + Biopsy → see if issue is with bone marrow
• Look for underlying cause
• Flowchart for Investigation of Pancytopenia

Management Plan