Version June 2024
| Conditions | Commonly associated cytopenias | Other important findings |
| Infections | ||
Viral
| Anemia, neutropenia, and/or thrombocytopenia; may be due to direct bone marrow involvement Parvovirus typically causes isolated anemia due to an RBC maturation block | In viral hepatitis-induced liver disease, there may be a component of hypersplenism |
Bacterial, fungal, or mycobacterial infections
| Anemia, neutropenia, and/or thrombocytopenia; may be due to sepsis (cytokine effect) and/or bone marrow involvement | Fever (may be acute or chronic) |
Protozoal
| Visceral leishmaniasis may cause pancytopenia Malaria usually causes anemia and sometimes thrombocytopenia or leukopenia | |
| Medications | ||
Antifungals and antibiotics
| Anemia, neutropenia, and/or thrombocytopenia | Some oxidant drugs may cause hemolytic anemia with high reticulocyte count |
Antiviral agents
| Anemia, neutropenia, and/or thrombocytopenia | Refer to individual drug information monographs |
| Cytotoxic chemotherapy drugs | Anemia, neutropenia, and/or thrombocytopenia | Refer to individual drug information monographs |
| Malignancies or lymphoproliferative disorders | ||
Lymphoma or leukemia
| Anemia, neutropenia, and/or thrombocytopenia With lymphoma or CLL, cytopenias can be due to autoimmune destruction or bone marrow infiltration With acute leukemias, cytopenias are due to bone marrow involvement and are usually severe | Lymphoid malignancies are often associated with EBV or HHV8; lymph node enlargement is typical |
| Multicentric Castleman disease | Anemia, neutropenia, and/or thrombocytopenia | Typically HHV8-associated; lymph node enlargement is typical |
| Kaposi sarcoma (rare) or other metastatic tumors | Anemia, neutropenia, and/or thrombocytopenia | Bone marrow involvement |
| Immune-mediated disorders | ||
| Autoimmune destruction | AIHA and ITP most common; autoimmune neutropenia can also occur | Normal blood cell production in the bone marrow; AIHA has high reticulocyte count and positive DAT |
| Hemophagocytic lymphohistiocytosis (HLH) | Pancytopenia, typically severe | Fever, coagulopathy, neurologic findings, extremely high ferritin, hemophagocytosis in the bone marrow |
| Inflammatory state from HIV, other infection, or other chronic condition | Can cause anemia of chronic disease | |
| Other | ||
| Hypersplenism | Anemia, neutropenia, and/or thrombocytopenia, typically mild | Typically caused by liver disease |
Nutrient deficiencies
| Iron deficiency causes isolated anemia; the other deficiencies can cause anemia, neutropenia, and/or thrombocytopenia, typically mild | Iron deficiency causes microcytosis; the other deficiencies cause megaloblastic changes (macrocytosis and multilobed PMNs) |
Thrombotic microangiopathies (TMAs)
| Anemia and thrombocytopenia | Schistocytes on the blood smear; neurologic and/or renal impairment |
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