-
Blood Reviews Sep 2018Pancytopenia is a relatively common phenomenon encountered in clinical practice. The evaluation of a patient with pancytopenia requires a comprehensive approach and... (Meta-Analysis)
Meta-Analysis Review
Pancytopenia is a relatively common phenomenon encountered in clinical practice. The evaluation of a patient with pancytopenia requires a comprehensive approach and identifying the underlying cause can be challenging given the wide range of etiologies including drugs, autoimmune conditions, malignancies, infections, hemophagocytosis, and inheritable conditions. Recent advances in molecular hematology which include genomic profiling and next-generation sequencing have helped gain major insights into various hematological conditions and can guide diagnosing specific diseases in a shorter time at lower costs. However the approach to manage patients with pancytopenia in the current era of genomics is not well defined in the literature and is widely variable in practice. Herein, we conducted a systematic review to help devise an algorithm and management approach for pancytopenia, which serves as a general consultative approach.
Topics: Algorithms; Blood Cell Count; Bone Marrow; Diagnosis, Differential; Disease Management; Humans; Pancytopenia; Practice Patterns, Physicians'; Research
PubMed: 29555368
DOI: 10.1016/j.blre.2018.03.001 -
Veterinary Journal (London, England :... Apr 2019Canine monocytic ehrlichiosis (CME), caused by Ehrlichia canis, a gram-negative, obligate intracellular bacterium, is a tick-borne disease of worldwide distribution.... (Review)
Review
Canine monocytic ehrlichiosis (CME), caused by Ehrlichia canis, a gram-negative, obligate intracellular bacterium, is a tick-borne disease of worldwide distribution. Experimentally, the course of E. canis infection can be sequentially divided into acute, subclinical and chronic phases, although distinction of these phases is challenging in the clinical setting. Spontaneous clinical recovery of acutely infected dogs is common; however, dogs at this stage require medical treatment in order to hasten their clinical recovery, and to prevent clinical exacerbation or death. An unpredictable proportion of subclinically infected dogs will eventually develop the chronic, severe form of ehrlichiosis, characterized by aplastic pancytopenia and high mortality. The aims of antimicrobial treatment in CME include the achievement of clinical remission, resolution of the clinicopathologic abnormalities, and eradication of the infection, although the latter is not always feasible or diagnostically confirmable. Treatment of dogs with aplastic pancytopenia should be undertaken with the clear understanding that medical management will require long-term care, will be expensive, and may eventually prove ineffective. This manuscript reviews the current state of knowledge regarding treatment of ehrlichiosis, caused by E. canis infection in dogs, provides expert opinion guidelines for the management of the CME-associated aplastic pancytopenia, and outlines methods for evaluation of treatment outcomes.
Topics: Animals; Anti-Bacterial Agents; Dog Diseases; Dogs; Ehrlichia canis; Ehrlichiosis; Pancytopenia; Treatment Outcome
PubMed: 30902188
DOI: 10.1016/j.tvjl.2019.01.015 -
British Journal of Haematology Mar 2024Pancytopenia with hypocellular bone marrow is the hallmark of aplastic anaemia (AA) and the diagnosis is confirmed after careful evaluation, following exclusion of...
Pancytopenia with hypocellular bone marrow is the hallmark of aplastic anaemia (AA) and the diagnosis is confirmed after careful evaluation, following exclusion of alternate diagnosis including hypoplastic myelodysplastic syndromes. Emerging use of molecular cyto-genomics is helpful in delineating immune mediated AA from inherited bone marrow failures (IBMF). Camitta criteria is used to assess disease severity, which along with age and availability of human leucocyte antigen compatible donor are determinants for therapeutic decisions. Supportive care with blood and platelet transfusion support, along with anti-microbial prophylaxis and prompt management of opportunistic infections remain key throughout the disease course. The standard first-line treatment for newly diagnosed acquired severe/very severe AA patients is horse anti-thymocyte globulin and ciclosporin-based immunosuppressive therapy (IST) with eltrombopag or allogeneic haemopoietic stem cell transplant (HSCT) from a matched sibling donor. Unrelated donor HSCT in adults should be considered after lack of response to IST, and up front for young adults with severe infections and a readily available matched unrelated donor. Management of IBMF, AA in pregnancy and in elderly require special attention. In view of the rarity of AA and complexity of management, appropriate discussion in multidisciplinary meetings and involvement of expert centres is strongly recommended to improve patient outcomes.
Topics: Young Adult; Humans; Aged; Anemia, Aplastic; Immunosuppressive Agents; Cyclosporine; Hematopoietic Stem Cell Transplantation; Bone Marrow Failure Disorders; Unrelated Donors; Pancytopenia; Hematology
PubMed: 38247114
DOI: 10.1111/bjh.19236 -
BMJ Case Reports Jul 2018Linezolid is a bacteriostatic antibiotic of the Oxazolidinone class; it works by inhibiting the initiation of protein synthesis on bacterial ribosomes. Due to its...
Linezolid is a bacteriostatic antibiotic of the Oxazolidinone class; it works by inhibiting the initiation of protein synthesis on bacterial ribosomes. Due to its excellent bioavailability after oral dosing, it has become an important tool in combating multi-drug-resistant bacteria including glycopeptide-resistant enterococci and methicillin-resistant Side effects are multiple and potentially serious. We report the case of an 87-year-old man who developed pancytopenia secondary to a 6-week course of linezolid. Withdrawal of the antibiotic was decided as the treatment and resolution of the pancytopenia was evident within 2 weeks. Clinicians should be aware of this side effect of linezolid therapy and that weekly full blood count monitoring is paramount.
Topics: Aged, 80 and over; Anti-Bacterial Agents; Arthroplasty, Replacement, Knee; Diagnosis, Differential; Humans; Linezolid; Male; Methicillin-Resistant Staphylococcus aureus; Pancytopenia; Staphylococcal Infections; Surgical Wound Infection
PubMed: 30054325
DOI: 10.1136/bcr-2018-225480 -
The Primary Care Companion For CNS... Sep 2022
Topics: Cannabis; Hallucinogens; Humans; Pancytopenia
PubMed: 36084655
DOI: 10.4088/PCC.21cr03155 -
Acta Neurologica Belgica Aug 2023
Topics: Humans; Levetiracetam; Pancytopenia; Anticonvulsants; Piracetam
PubMed: 36344882
DOI: 10.1007/s13760-022-02138-1 -
American Journal of Therapeutics
Topics: Humans; Leflunomide; Pancytopenia; Antirheumatic Agents; Methotrexate
PubMed: 35404332
DOI: 10.1097/MJT.0000000000001497 -
JAMA Feb 2020
Topics: Adolescent; Bone Marrow; Career Choice; Female; Humans; Medical Oncology; Pancytopenia
PubMed: 32044946
DOI: 10.1001/jama.2020.0252 -
Hepatology (Baltimore, Md.) Dec 2018Idiopathic portal hypertension (IPH) is a rare disorder characterized by clinical portal hypertension in the absence of a recognizable cause such as cirrhosis.... (Review)
Review
Idiopathic portal hypertension (IPH) is a rare disorder characterized by clinical portal hypertension in the absence of a recognizable cause such as cirrhosis. Laboratory tests often reveal a preserved liver function with anemia, leukopenia, and thrombocytopenia due to splenomegaly. Imaging studies reveal signs of portal hypertension, whereas liver stiffness and portal pressure values are usually normal or slightly elevated. Liver biopsy is considered mandatory in order to rule out other causes of portal hypertension, mainly cirrhosis. Liver histology may only show subtle or mild changes, and the definite diagnosis of IPH often requires an expert pathologist and a high-quality specimen. The most frequent clinical presentation is variceal bleeding. Ascites is rarely observed initially, although it may occasionally appear during follow-up. Typical histological findings associated with IPH have been described in patients without portal hypertension, probably representing early stages of the disease. Although the pathophysiology of this entity remains largely unknown, it is frequently associated with underlying immunological disorders, bacterial infections, trace metal poisoning, medications, liver circulatory disturbances, and thrombotic events. The long-term prognosis of patients with IPH, where ascites and the underlying condition are important prognostic factors, is better than in patients with cirrhosis. Treatments that modify the natural history of the disease remain an unmet need, and management of IPH is frequently restricted to control of portal hypertension-related complications.
Topics: Animals; Humans; Hypertension, Portal; Liver Cirrhosis; Pancytopenia; Splenomegaly; Idiopathic Noncirrhotic Portal Hypertension
PubMed: 30066417
DOI: 10.1002/hep.30132 -
The Journal of the Association of... Apr 2022Current study intends to study the etiological profile of Pancytopenia and to identify the complete blood count (CBC), peripheral smear (PS) findings which are helpful... (Observational Study)
Observational Study
UNLABELLED
Current study intends to study the etiological profile of Pancytopenia and to identify the complete blood count (CBC), peripheral smear (PS) findings which are helpful in narrowing the differential diagnosis and in planning the additional investigations to arrive at a specific diagnosis.
MATERIAL
Hospital based observational study being conducted at tertiary centre, Jaipur.
INCLUSION CRITERIA
Patients >18 years, CBC on admission fulfilling criteria of pancytopenia as mentioned in definition.
EXCLUSION CRITERIA
Patients > 80 years, Patients on radiotherapy and chemotherapy., Observation :Mean age of patients was 35.42 years with majority (29.90%) patients with majority of patients were in 2nd and 3r decade of their life with male preponderance Male: female ratio is 1.15:1). Vitamin B-12 deficiency (34.02%), folate deficiency (18.55%) CLD (9.27%) were the most common cause of pancytopenia.
CONCLUSION
Detailed clinical history and meticulous physical examination along with baseline hematological investigations, provides invaluable information in the complete workup of pancytopenic patients, helping in systematic planning of further investigations to diagnose and ascertain the cause.
Topics: Adult; Blood Cell Count; Diagnosis, Differential; Female; Folic Acid Deficiency; Humans; Male; Pancytopenia; Vitamin B 12 Deficiency
PubMed: 35443537
DOI: No ID Found