Download Pancytopaenia - Wellington ICU

Full Blood Count
13/12/10
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Examinations Book
Data Interpretation – Venkatesh
RED BLOOD CELLS
ANAEMIA
Decreased production – nutritional deficiencies/malasorption, marrow failure, low level of
hormones (EPO, thyroid hormones)
Increased production – haemolytic anaemia (congenital/acquired)
Bleeding
Haemodilution
MCV
Anaemia with low MCV - microcytosis
- Fe deficiency
- thalassaemia
- sideroblastic anaemia
Anaemia with high MCV - macrocytosis
-
folate or B12 deficiency
alcohol abuse
chronic liver disease
hypothyroidism
reticulocytosis
myelodysplasia
Anaemia with normal MCV
-
chronic disease
chronic renal failure
pregnancy
haemolysis
bone marrow failure
mixed haematinic deficiency (Fe, B12)
Macrocytosis
-
alcohol
B12 deficiency
folate deficiency
myelodysplastic syndrome
therapy with cytotoxics or immunosuppressants
hypothyroidism
Jeremy Fernando (2011)
POLYCYTHAEMIA (Hb > 160g/L)
Relative (reduced plasma volume)
- burns
- severe dehydration
Absolute
- polycythaemia ruba vera
- myeloproliferative disorders
- chronic hypoxia (OSA, Eisenmenger’s)
RETICULOCYTOSIS
- acute blood loss
- any cause of premature RBC destruction
WHITE BLOOD CELLS
NEUTROPHILIA
-
stress
sepsis
leukemoid reactions
corticosteroids
malignancy
vasculitis
NEUTROPAENIA
- infection
- cytotoxic agents
- idiosyncratic drug reactions (clozapine, carbimazole, sulphonamides, beta-lactams)
LYMPHOPENIA
-
simple stress response
prior corticosteroid therapy
autoimmune disease (SLE)
infection: viral, severe sepsis, Tb, brucelliosis, histoplasmosis, HIV, CVM
cytotoxic drugs
radiation
LYMPHOCYTOSIS
Jeremy Fernando (2011)
-
infection: viral, Tb, toxoplasmosis, syphilis
thyrotoxicosis
leukaemia
lymphoma
ATYPICAL LYMPHOCYTES
-
viral infections: EBV, CMV, HIV
toxoplasmosis
leukaemia
lymphoma
lead poisoning
drug hypersensitivity
MONOCYTOSIS
-
Tb
leukaemia
lymphoma
myelodysplasia
IBD
convalescence from any infection
EOSINOPHILIA
-
allergy
Addisons
parasitic infections
sarcoidosis
polyarteritis nodosa
leukaemia
lymphoma
melanoma
irradiation
convalescence from any infection
BASOPHILIA
-
infection: viral, Tb
hypothyroidism
IBD
polysplenectomy
leukaemia
systemic mastocytosis
haemolysis
polycythaemia ruba vera
PANCYTOPAENIA
Reduced Marrow Production
Jeremy Fernando (2011)
- replacement of marrow (malignant cells)
- idiosyncratic Drug Reaction (chloramphenicol, sulphonamides, phenytoin, carbamazepine,
gold)
- megaloblastic haematopoiesis (B12 deficiency)
- autoantibodies (SLE)
- myelofibrosis
- myelodysplasia
- toxins (benzene)
- cytotoxic agents
- overwhelming infections
Increased Peripheral Cellular Destruction
-
SLE
HIV infection
hypersplenism
paroxysmal nocturnal haemoglobinuria
THROMBOCYTOPAENIA
Pseudothrombocytopaenia
-> film
-> blue tube
Decreased Production
- bone marrow failure
- pernicious anaemia
Increased Destruction
-
sepsis
immune (ITP, TTP, HUS, HITTS)
intravascular device (IABP, ECMO, PAC, bypass)
drug induced (antibiotics, thiazides, H2 antagonists)
antiphospholipid syndrome
DIC
HELLP
haemolysis
Dilution
- post resuscitation
- massive transfusion
Jeremy Fernando (2011)