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Pancytopenia


Pancytopenia means anemia,granulocytopenia,thrombocytopenia.

Causes
1. Pan. with cellular böne marrow
-myelodysplastic synd
-myelofibrosis
-myelophthisis
-hairy cell leukemia
-paroxysmal nocturnal hemoglobinuria
-hypersplenism
-folate/vit b12 def
-SLE,TB
2. Pan. with hypocellular bone marrow
-aplastic anemia
-aleukemic leukemia
-some myelodysplastic synd.

C/f
-anemia results in weakness fatigue..lassitude.dyspnea on exertion n pallor.
-granulo. results in uarious infection,sore throad,oral n pharyngeal ulcers,fever wid chills,chronic skin inf,pneumonia n septicemia
-thrombo. results in various bleeding manifestation.these include ecchymosis,petechiae,epistaxis,menorrhagia,bleeding frm gums.

Diagnosis
-low reticulocyte count.
-Hb is reduced
-markedly hypo or acellular marrow.
-increase in fat cells
-bone marrow iron stores r increased
-serum iron n transferrin saturation inc.
-hemopoietic cells are absent or reduced.
-peripheal smear study shows neutropenia,normocytic normochr.anemia

Treatment
-removal of the causative agent whenever possible.
-prevention and treatment of infections and hemorrhage and see cell transfusion for anemia.
-bone marrow transplant under the age of 50 who have HLA identical donors.
-antilymphocyte globulin or antithymocyte g.dose is 10-20 mg/kg daily for 8-14 days with prednisolone 1mg/kg.
-cyclosporine 3-7mg/kg/day
-combine ALG or ATG wid cyclo.

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