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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/10/14 08:53:36」(JST)

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Pancytopenia is a medical condition in which there is a reduction in the number of red and white blood cells, as well as platelets.

If only two parameters from the full blood count are low, the term bicytopenia can be used. The diagnostic approach is the same as for pancytopenia.

Definition

anemia: hemoglobin < 13.5 g/dL (male) or 12 g/dL (female).
leukopenia: total white cell count < 4.0 x 10⁹/L. Decrease in all types of white blood cells (revealed by doing a differential count).
thrombocytopenia: platelet count < 150×10⁹/L.

The disease is marked by an inappropriate and ineffective T cell activation that leads to an increased hemophagocytic activity. The T cell activated macrophages engulf erythrocytes, leukocytes, platelets, as well as their progenitor cells. Such finding is common in the syndrome, which is also referred to as hemophagocytic lymphohistiocytosis (HLH). Along with pancytopenia, HLH is characterized by fever, splenomegaly, and hemophagocytosis in bone marrow, liver, or lymph nodes.

Iatrogenic causes of pancytopenia include chemotherapy for malignancies if the drug or drugs used cause bone marrow suppression. Rarely, drugs (antibiotics, blood pressure medication, heart medication) can cause pancytopenia. The antibiotics Linezolid and Chloramphenicol can cause pancytopenia in some individuals.

Rarely, pancytopenia may have other causes, such as mononucleosis, or other viral diseases. Increasingly, HIV is itself a cause for pancytopenia.

Causes

Familial hemophagocytic syndrome
Aplastic anemia
Iron Deficiency anemia
Gaucher's disease
metastatic carcinoma of bone
Multiple Myeloma
overwhelming infections
Lymphoma
myelofibrosis
Dyskeratosis congenita
Myelodysplastic syndrome
Leukemia
Leishmaniasis
Severe Folate or vitamin B12 deficiency
Systemic lupus erythematosus
Paroxysmal nocturnal hemoglobinuria (blood test)
viral infections (such as HIV, EBV--undetermined virus is most common).
Alimentary toxic aleukia
Copper deficiency
Pernicious anemia
Medication
Hypersplenism
Osteopetrosis
Organic acidurias (Propionic Acidemia, Methylmalonic Aciduria, Isovaleric Aciduria)
Low dose arsenic poisoning
Sako disease (Myelodysplastic-cytosis)
Chronic radiation sickness^[1]
LIG4 syndrome

Diagnosis

Pancytopenia usually requires a bone marrow biopsy in order to distinguish among different causes.

References

^ Kossenko MM, Akleyev AA, Degteva MO, Kozheurov VP, Degtyaryova RC (August 1994). "Analysis of Chronic Radiation Sickness Cases in the Population of the Souther Urals (AD-A286 238)" (PDF). DTIC. p. 5. Retrieved 1 August 2013. Complete blood counts, when taken, revealed pancytopenia.

External links

EID Journal (Volume 6, Number 6), CDC, December 2000.
Aetiopancyto – Université Angers

UpToDate Contents

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English Journal

Cutaneous Manifestation of Underlying Disseminated Histoplasmosis in an Immunocompetent Host of Nonendemic Area with Reversible CD4 Cell Depletion and its Recovery on Antifungal Therapy.

Bharti P1, Bala K, Gupta N.
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We present the case of an 18-year-old male patient admitted with complaints of fever and rapid weight loss since 3 months. Patient had multiple umbilicated papular to nodular lesions over chin and forehead region. Complete blood count revealed bicytopenia. An excisional biopsy of the skin lesions h
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Hemophagocytic lymphohistiocytosis: an unusual complication of leprosy.

Saidi W1, Gammoudi R1, Korbi M1, Aounallah A1, Boussofara L1, Ghariani N1, Sriha B2, Braham N3, Denguezli M1, Belajouza C1, Nouira R1.
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Posterior reversible leukoencephalopathy syndrome with spinal cord involvement in a 9-year-old girl.

Yiş U1, Karaoğlu P2, Kurul SH2, Soylu A3, Çakmakçi H4, Kavukçu S3.
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Japanese Journal

Clinicopathological Analysis of Hematological Disorders in Tube-Fed Patients with Copper Deficiency

Chen Chun Chuan,Takeshima Fuminao,Miyazaki Takashige,Murase Kunihiko,Ohtani Hiroshi,Isomoto Hajime,Shikuwa Saburo,Omagari Katsuhisa,Mizuta Yohei,Ozono Yoshiyuki,Kohno Shigeru
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… After copper supplementation, these pathological changes disappeared.Conclusions Bicytopenia is likely to occur in tube-fed patients with copper deficiency. …
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Hemophagocytic syndrome associated with rheumatoid arthritis: A case report and review of the literature

Katoh Nagaaki,Gono Takahisa,Mitsuhashi Shigeaki,Fukushima Kazuhiro,Takei Yo-ichi,Matsuda Masayuki,Ikeda Shu-ichi
INTERNAL MEDICINE 46(21), 2007
… We report a patient with rheumatoid arthritis (RA) who showed bicytopenia with hyperferritinemia and hepatic dysfunction ascribable to hemophagocytic syndrome (HPS) 2 weeks after commencement of bucillamine. …
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