Pancytopenia has a very broad differential diagnosis. Fortunately, for a 76-year-old
woman with abnormal blood counts, the cause was easily treated. The patient presented
to the Emergency Department of our hospital after 10 days of fever, malaise, and anorexia.
Daily fevers had been as high as 38.9°C (102°F). She also reported an unintentional
4.5-kg (10-lb) weight loss over the preceding month. She had no sore throat, cough,
dyspnea, headache, neck stiffness, abdominal pain, nausea, emesis, diarrhea, dysuria,
joint pains, or rashes.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Case 29-2003: a 60-year-old man with fever, rigors, and sweats.N Engl J Med. 2003; 49: 2467
- Pancytopenia in Lyme disease.BMJ Case Rep. 2014; 2014https://doi.org/10.1136/bcr-2013-201079
- Anaplasma phagocytophilum and Ehrlichia muris induce cytopenias and global defects in hematopoiesis.Clin Microbiol Infect. 2009; 15: 66-67
- The agent of human granulocytic ehrlichiosis induces the production of myelosuppressing chemokines without induction of proinflammatory cytokines.J Infect Dis. 2000; 182: 200-205
- Human granulocytic anaplasmosis surveillance in Massachusetts.(Available at)https://www.mass.gov/files/documents/2018/01/02/HGH%202016.pdfDate: 2016Date accessed: March 23, 2018
- Human granulocytic anaplasmosis surveillance in Massachusetts.(Available at)https://www.mass.gov/files/documents/2018/01/02/HGA%202013.pdfDate: 2013Date accessed: March 23, 2018
- Human granulocytic anaplasmosis in the United States from 2008 to 2012: a summary of national surveillance data.Am J Trop Med Hyg. 2015; 93: 66-72
- Human granulocytic ehrlichiosis.Clin Infect Dis. 2000; 31: 554-560
- Disease-specific diagnosis of coinfecting tickborne zoonoses: babesiosis, human granulocytic ehrlichiosis, and Lyme disease.Clin Infect Dis. 2002; 34: 1184-1191
Article info
Publication history
Published online: April 09, 2018
Thomas J. Marrie, MD, Section EditorFootnotes
Funding: None.
Conflicts of Interest: The authors report no relationships that could be construed as a conflict of interest.
Authorship: Both authors had access to the data and a role in writing this manuscript.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
