D60.0-1/D60.8-9/D61.0-3/D61.8-9
DESCRIPTION
Pancytopenia due to a hypoplastic bone marrow.
Clinical features:
- pallor
- purpura
- petechiae
- bleeding
- frequent or severe infections
Pancytopenia in HIV positive patients B23.2 + (D61.0/D61.9)
Most common causes include:
Direct effect of HIV, medication, secondary opportunistic infections, malignancies and nutritional deficiencies. Many cases are idiopathic.
Investigations
- FBC smear (FBC indicates different degrees of: anaemia, thrombocytopaenia and leucopaenia).Vitamin B12 and red cell folate.
- Appropriate investigation to exclude opportunistic infections.
- Bone marrow trephine and aspiration in selected patients (where no other cause is found, in patients with persistent pancytopaenia) to exclude infiltration with opportunistic infections, malignancies, etc.
MEDICINE TREATMENT
If neutropenic and febrile, see Febrile neutropenia.
REFERRAL
Discuss all cases of suspected aplastic anaemia with a specialist. (Stabilise patient, if necessary, with blood products before transport but after consultation with an expert).