2. overview
• Pancytopenia mean: Reduction in the all major
cellular component of the peripheral blood below
the lower limits
RBCs
WBCs
PLTs
• Reduction in two referee ass Bicytopenia
- Anemia + thrombocytopenia- 77.5%
- Anemia + leukopenia- 17.3%
- Thrompocytopenia + leukopenia- 5.5%
3. Causes
• Reduce production
- Infiltration
- Marrow failure
- Ineffective marrow production
• Peripheral Destruction
- Hypersplenism
4. • Diagnosis made by results of CBC
- Anaemia
- Leukopenia
- Thrombocytopenia
6. • Aplastic anemia: stem cell disorder, which Bone
marrow stop making cells, common age 7 yrs
- Presentation is with ecchymosis and petechiae
- Lead to anemia, infection, bleeding tendency
- Autoimmune triggered by drug, viruses or
irradiation
- Bone marrow biopsy is diagnostic
- Management is only supportive in asymptomatic
pt also transfusion can solve a lot of complication
7. • Brucellosis : zoonotic infection
pathogen's tropism for central (bone marrow) and
peripheral (spleen) organs of the reticuloendothelial
system (RES).
Causes: ingested raw animal milk and, positive family
history of brucellosis
symptoms and signs included; excessive sweating (68%),
bone aches (62%), chills (55%), arthritis (32%), and
hepatosplenomegaly, petechiea and purpura
a rapid slide serum agglutination test for presence of (B.
melitensis) is diagnostic
18. Plane of treatment
• Transfusions of RBCs and Platelets as needed
• AB Prophylaxes
• Prophylactic B12 vitamin
• Corticosteroids
• Androgenic therapy
• Bone marrow transplant from an HLA-
compatible donor is curable.
20. Problem solving
• infant was delivered via spontaneous vaginal delivery at 384 weeks’
gestational age. She was born following in vitro fertilization to a 31-
year-old primigravida mother known to have hypothyroidism. There
was no reported consanguinity between the parents. Maternal
toxoplasmosis, other (syphilis, varicella-zoster, parvovirus B19),
rubella, cytomegalovirus and herpes infections (TORCH) serology
was negative and her blood count was normal. Fetal ultrasound
revealed an absent right kidney but otherwise normal anatomy.
Integrated prenatal screen was normal. The mother received one
prophylactic dose of penicillin G for group B Streptococcus-positive
status. At delivery, the infant had normal vital signs and no
dysmorphic features; however, she was pale, with a ‘blueberry’ rash
(palpable purpura-petechiae) covering her entire body (Figure 1)
21.
22. • The first complete blood count performed after birth revealed a
hemoglobin level of 5.2 g/L, platelet count of 3×109/L and a
relatively low white blood cell count (6.1×109/L) but normal
neutrophil count (1.6×109/L). She immediately received platelet and
red blood cell transfusions. Five days later, she developed severe,
persistent. A fundoscopic examination revealed bilateral retinal
hemorrhages. Magnetic resonance imaging of the brain revealed
multiple small cortical petechial hemorrhages
Q:
1. What’s the diagnosis?
2. How to confirm ur diagnosis ?
3. Plane of management ?