Abstract:
Detection of neutropenia depends on the white cell count and the differential count, both of which involve considerable error. Pathogenetically, neutropenia can be attributed one of the following mechanisms: insufficient (or inefficient) formation, enhanced destruction or utilization, or--rarely--shift to the marginal pool. Isolated neutropenia should be distinguished from neutropenia combined with anemia and/or thrombocytopenia. The latter is usually due to bone marrow failure, whereas the former depends on peripheral mechanisms. Drug induced neutropenia may appear either as unforeseen acute agranulocytosis (aminophenazone type), depending on preceding sensitization, or as a slowly developing, dose-dependent cytopenia. Gradually developing neutropenia is an early stage of a general disease (collagen diseases, leukemia and other neoplasias, infections).Keywords:
Cytopenia
Leukopenia
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Detection of neutropenia depends on the white cell count and the differential count, both of which involve considerable error. Pathogenetically, neutropenia can be attributed one of the following mechanisms: insufficient (or inefficient) formation, enhanced destruction or utilization, or--rarely--shift to the marginal pool. Isolated neutropenia should be distinguished from neutropenia combined with anemia and/or thrombocytopenia. The latter is usually due to bone marrow failure, whereas the former depends on peripheral mechanisms. Drug induced neutropenia may appear either as unforeseen acute agranulocytosis (aminophenazone type), depending on preceding sensitization, or as a slowly developing, dose-dependent cytopenia. Gradually developing neutropenia is an early stage of a general disease (collagen diseases, leukemia and other neoplasias, infections).
Cytopenia
Leukopenia
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Over decades, HIV infection and its complications have been one of the most debated problems in the world. The human immunodeficiency virus not only weaken the immune system, but also disrupts normal hematopoiesis manifested as cytopenia (anemia, thrombocytopenia and neutropenia). Materials and methods. A retrospective analysis of cases of combined HIV infection and inhibited hematopoiesis was carried out according to hemogram data of patients admitted for treatment at the Infectious Clinical Hospital No. 1 named after D. Dalmatov, Omsk. The inclusion criteria were cytopenia during hospitalization detected in detailed blood test (by calculating hemoglobin level, counts of erythrocytes, leukocytes, platelets). The age of the patients included in the study differed: from 20 to 29 years — 27 patients (24.6%), from 30 to 39 years — 69 patients (62.7%), from 40 to 49 years — 13 patients (11.8%), over 50 years old 1 patient (0.9%). All patients had suppression of at least one hematopoietic cell lineage. Anemia was considered as decreased hemoglobin level below than 130 g/l in men and 120 g/l in women. Erythrocytopenia was considered as decreased erythrocyte count below 4.76 × 1012/L. Leukopenia was defined as decreased total count of leukocytes below 4.0 × 109/L, while a decrease in the absolute count of neutrophils below 1000 cells/μL was considered as neutropenia. Thrombocytopenia was determined as decreased platelet count below 150 × 109/L. Results. All patients had suppression of at least one hematopoietic cell lineage. 6 patients with stage 2 had one-cell lineage cytopenias, 7 — two-cell lineages. While analyzing the data obtained, it can be concluded that in patients with stage 2 HIV, inhibition of erythroid and platelet cell lineage predominates, whereas thrombocytopenia reached grade IV. At stage 3 HIV, all 7 patients had inhibition of only one cell lineage. In this group, the inhibition of hematopoiesis had a lighter degree in all hematopoietic cell lineages. In 46 patients with stage 4, there were various oppression of one of the hematopoietic cell lineages, in 44 patients there were two-cell lineage cytopenias. For patients with a more advanced stage of HIV, a decrease in the number of all cellular elements of the blood in the hemogram is characteristic; these disorders are more severe and persistent.
Cytopenia
Leukopenia
Blood cell
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The causes of cytopenia in patients with severe fever with thrombocytopenia syndrome (SFTS) are not fully understood until now. We reviewed the bone marrow (BM) findings of patients with SFTS to unravel the cause of the cytopenia. Three Korean SFTS were enrolled in this study. Thrombocytopenia, neutropenia, and anemia were detected in all three patients. Severe hypocellular marrow (overall cellularity <5%) and a decreased number of megakaryocytes were noted in one patient, and hypo-/normocellular marrow and an increased number of hemophagocytic histiocytes were observed in two patients. Megakaryocytes were relatively preserved in two patients. Although a limited number of cases are available, our observations suggest that both BM suppression and peripheral destruction or sequestration are causes of cytopenia of patients with SFTS. To the best of our knowledge, this is the first well documented pathologic evaluation of Korean SFTS.
Cytopenia
Leukopenia
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Introduction: Cytopenia is one of the most important side effects of chemotherapy. It presents as pancytopenia or bicytopenia or monocytopenia. Cytopenia is a challenging factor for delivering chemotherapy drugs. Methods:Â In this study we were looking for the incidence of cytopenia in patients received chemotherapy in two different hospitals. Results: 200 patients were included in our study. Most of the patients were female and anemia was the most adverse effect which was followed by leukopenia and thrombocytopenia. Bicytopenia and pancytopenia were the least side effects of chemotherapy drugs. Conclusion: Although our study was not a head to head one anemia was the most adverse effect following systemic chemotherapy in both hospitals. Overall cytopenia was more prevalent in the university hospital than private hospital. This difference was significant for anemia (P-value âﾂ・curren; 0.05) but it wasn’t for leukopenia or thrombocytopenia. Bicytopenia and pancytopenia happened very rarely.
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Leukopenia
Abnormality
Absolute neutrophil count
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Immunophenotyping
Cytopenia
Hairy Cell
Leukocytosis
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Cytopenia
Leukopenia
Dyscrasia
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Zinc-induced hypocupremia and pancytopenia, from zinc supplementation to its toxicity, a case report
According to one estimate, zinc supplementation is widely used in the USA by almost 37% of the elderly population above age 71. Zinc has perceived benefits of immune system enhancement without realizing the harmful effects when used in excess. One of its under-recognized side effects is hypocupremia or copper deficiency due to excessive gastrointestinal losses as excessive zinc in the gut competes with copper for absorption. If severe, hypocupremia can cause hematologic changes (anemia, leukopenia/neutropenia, thrombocytopenia, and pancytopenia) with and without neurological deficits. Since zinc-induced hypocupremia is an overlooked entity, there is a lag of 12 months between the onset of symptoms and diagnosis. Most patients usually undergo a series of costly and sometimes invasive tests such as bone marrow biopsies during this lag time. Once diagnosed, the treatment is as simple as discontinuation of zinc and oral copper supplements. Here, we present a case report of zinc-induced hypocupremia and pancytopenia in an 81-year-old lady who was taking zinc supplements for macular degeneration. The patient presented with leukopenia with neutropenia, thrombocytopenia, and moderate anemia. This case report aims to educate clinicians since this is an easily missed entity and likely more prevalent than known due to widely used zinc supplementation.
Leukopenia
Discontinuation
Copper deficiency
Zinc toxicity
Cytopenia
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Abstract Objective: Changes of the peripheral blood cell count in patients with anorexia nervosa (AN) are frequent. Anemia and leukopenia are observed in one‐third of these patients. Examination of the bone marrow reveals in almost 50% of the patients with AN signs of bone marrow atrophy and can additionally suffer from a gelatinous bone marrow transformation. Method: Published studies and investigations concerning hematological changes in patients with AN were reviewed. Results: Anemia and mild neutropenia are detectable in almost one‐third of these patients, whereas thrombocytopenia is rather uncommon. The exact mechanism for these findings is still unclear, but 50% of AN‐patients with hematological changes display morphological signs of partial bone marrow atrophy. Discussion: Changes of the peripheral blood cell count in patients with AN is a frequent observation but the peripheral blood cell count cannot predict the severity of bone marrow atrophy. All hematological and morphological alterations disappear completely and rapidly after sufficient refeeding. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2009
Leukopenia
Anorexia nervosa
Hematology
Anorexia
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Background: AIDS, caused by HIV, is a multisystem disease that affects hematopoiesis. The aim of this study was to assess cytopenias among HIV-infected children who had a follow-up at Felege Hiwot Referral Hospital, Bahir Dar, northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted between April and May 2013. Systematic random sampling method was used to select the study participants. Descriptive statistics, independent t -test as well as chi-square and logistic regression were used for analysis. A p -value <0.05 was considered as statistically significant. Results: A total of 224 children (112 highly active antiretroviral therapy [HAART]-naïve and 112 HAART-experienced) participated in the study. The magnitude of anemia, thrombocytopenia, neutropenia, leukopenia and pancytopenia among HAART-naïve HIV-infected children were 30.4%, 9.8%, 8%, 4.5% and 1.8%, respectively. The overall prevalence of anemia, neutropenia, thrombocytopenia, leukopenia and pancytopenia were 29.5%, 8.9%, 8%, 4.5% and 1.4%, respectively. Cluster of differentiation-4 percentage and mean corpuscular volume were significantly different between HAART-experienced and HAART-naïve children. Being of younger age and severely immunosuppressed were risk factors of anemia. Conclusion: Anemia was the most common cytopenia, followed by neutropenia. Severe immunosuppression and younger age were significantly associated with anemia. Therefore, emphasis should be given for investigation and management of cytopenias in HIV-infected children, particularly for those who are immunosuppressed and of younger age. Keywords: anemia, children, cytopenia, HAART, HIV, leukopenia, neutropenia, pancytopenia, thrombocytopenia
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