Ross et al listed hematologic abnormalities that can be seen in a patient with a systemic vasculitis. The authors are from Norfolk and Norwich Hospital in England.
NOTE: The original table is index by category (disease-related, treatment-related, sepsis-related). The current table is indexed by the hematologic feature.
Hematologic features:
(1) anemia
(2) leukocytosis
(3) eosinophilia
(4) leukopenia
(5) thrombocytosis
(6) thrombocytopenia
(7) pancytopenia (anemia + leukopenia + thrombocytopenia)
|
Hematologic Feature |
Underlying Cause |
Features |
|
anemia |
anemia of chronic disease |
disease present for several years, exclusion of other causes |
|
|
hemorrhage, with blood loss anemia |
|
|
|
microangiopathic hemolytic anemia |
schistocytes, active vasculitis |
|
|
cytotoxic drugs |
|
|
leukocytosis |
active vasculitis |
|
|
|
sepsis |
clinical signs of sepsis, positive culture |
|
eosinophilia |
active vasculitis |
Wegener's granulomatosis or Churg Strauss |
|
|
allergic reaction to drugs |
|
|
leukopenia |
drug reaction |
|
|
|
hemodialysis |
|
|
|
plasma exchange |
|
|
|
cytotoxic drugs |
|
|
thrombocytosis |
active vasculitis |
|
|
thrombocytopenia |
DIC |
schistocytes, fibrin split products |
|
|
sepsis |
clinical signs of sepsis, positive culture |
|
|
systemic CMV infection |
immunosuppression, positive viral culture, inclusions in biopsy |
|
|
drug reaction |
|
|
|
cytotoxic drugs |
|
|
|
plasma exchange |
|
|
pancytopenia |
cytotoxic drugs |
|
|
|
drug reaction |
hypoplastic or aplastic marrow |
|
|
sepsis |
clinical signs of sepsis, positive culture |
Limitations:
• Masking can occur when opposite effects (thrombocytosis and thrombocytopenia, leukocytosis and leukopenia) occur at the same time.
Specialty: Hematology Oncology, Clinical Laboratory, Immunology/Rheumatology
