Bone marrow produces three distinct types of blood cells: red, white, and platelets. Anemia occurs when the quantity of red blood cells in the blood is low. Leukopenia is diagnosed when the white blood cell count is low. Thrombocytopenia is too few platelets. Pancytopenia is when all three of these conditions happen at the same time.
Red blood cells contain a special protein, hemoglobin, that carries oxygen from the lungs to all of the other tissues in the body, then returns carbon dioxide to the lungs. Not having enough red blood cells affects many systems throughout the body.
A diagnosis of pancytopenia also depends on the blood having too few white blood cells, the units that protect the body from infection. There are two types: neutrophils provide an immediate response, while lymphocytes directly attack infections and produce antibodies that target specific bacteria and viruses. The body needs an adequate amount of both to maintain a healthy immune system.
The third cell type affected in pancytopenia is platelets. These small fragments of cells help clot blood. They stick together at the site of an injury to form a base and stop active bleeding. Lower-than-normal platelet counts can lead to bleeding problems.
The bone marrow produces all three blood cell types. Initially, impairment causing pancytopenia may be mild, and the problem may go undetected or appear only during times of stress. Many factors can result in bone marrow failing to produce enough blood cells: inadequate production, defective cells, the formation of antibodies that cause the body to attack blood cells, or the replacement of marrow with abnormal cells.
Pancytopenia is a common blood condition with many possible causes. While a complete blood count test can identify pancytopenia, finding the cause requires further investigation. The doctor may check blood levels of iron, ferritin, and vitamin B12, test for antibodies, and conduct bone marrow aspiration.
Many conditions can cause pancytopenia, which is why it is quite common. Causes include infections, medication side effects, chemotherapy, radiation, cancer, bone marrow disorders, infections, nutritional deficiencies, alcohol abuse, environmental toxins, and autoimmune disorders. A family history of blood disorders also raises one's risk. In some cases, the cause is unknown and difficult to determine.
Signs of pancytopenia are varied and mimic those of many other conditions, so it is not always easy to confirm the severity of the problem. Symptoms vary in frequency and intensity and include fatigue, weakness, pale skin, rapid heartbeat, shortness of breath, frequent infections, rashes, and easy bruising. Bleeding gums, nosebleed, and internal bleeding may also occur.
If pancytopenia is not caught and treated early, serious symptoms may result. Without medical attention, individuals may develop seizures and convulsions, high fever, heavy bleeding, confusion, difficulty breathing, and loss of consciousness. These symptoms may appear gradually or hit all at once. When they begin to appear, the individual should be taken to the emergency room immediately.
Prognosis of pancytopenia depends on the underlying cause. For example, if someone experiences pancytopenia as a side effect of a medication or from exposure to a toxin, when the substance is removed, the person should recover. Prognosis is impossible to determine since the range of causes is so broad. In some cases, the condition itself may be easy to treat, but without identifying and treating the cause, it will recur.
To treat pancytopenia itself, a variety of interventions are required. These include drugs that suppress the immune system and stimulate the bone marrow, blood transfusions, and stem cell transplants. In mild cases, doctors may choose a watchful monitoring approach and see how the patient responds to treatment of the underlying cause.
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