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Pancytopenia - Differential Diagnosis

Congenital Diseases:
• GATA2 deficiency
• Fanconi’s anemia
• Wiskott-Aldrich syndrome
• Ribosomopathy or telomeropathy

Cancer:
• Leukemia
• Lymphoma

Inflammatory
• Fanconi’s anemia ... • Leukemia • Lymphoma ... hemolysis Nutritional ... Vitamin B12 • Folate ... #Diagnosis #Hematology
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
Hemolytic Anemia ... • Blood smear: Differential ... 2) LOOK FOR a cause ... #management #treatment ... #rheumatology
Causes of Anemia by Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Low Mean Corpuscular Volume (<80
Causes of Anemia ... Volume (MCV) - Differential ... • Bleeding • Hemolysis ... • Folate Deficiency ... #Hematology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
anemia): ... e.g. lupus, CLL, lymphoma ... G6PD deficiency) ... #differential # ... diagnosis #hematology
Red Blood Cell (RBC) Morphology
Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
Vitamin B12 or Folate ... IgM associated lymphoma ... disease, Malignant lymphoma ... RBC #Morphology #differential ... #diagnosis #hematology
Etiologies of Folate Deficiency
 • Decreased dietary intake - uncommon in this era
 • Increased requirements
pregnant have hemolytic ... anemia, or psoriasis ... that can cause ... #differential # ... diagnosis #hematology
SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
permanent alopecia Differential ... Non-autoimmune rheumatologic ... disease • Prolidase deficiency ... lymphopenia, low PLT • Anemia ... #Diagnosis #Rheumatology
Hodgkin's Lymphoma Overview

Hodgkin's lymphoma (HL) is an uncommon hematological malignancy arising from mature B cells. It
nodosum • Immune hemolytic ... anemia • Pain ... Immunohistochemical studies (to differentiate ... classification #hematology ... #oncology #management
Common Variable Immunodeficiency (CVID)

What?
CVID: Immunodeficiency disorder with hypogammaglobulinemia -> increased infection risk secondary to impaired B-cell
• Nodules • Lymphoid ... and autoimmune hemolytic ... anemia) • Systemic ... DDX - Other causes ... hypogammaglobulinemia #immunology #hematology