DIAGNOSTIC AND THERAPEUTIC FEATURES OF ANEMIA ACCOMPANIED BY PANCYTOPENIA

Abstract

This article presents the features of the differential diagnosis and treatment of severe anemia and pancytopenia observed by the authors in clinical practice in a 64-year-old male patient, and analyses the capabilities of the diagnostic tools available in general therapeutic practice. It is demonstrated that, in order to determine the type of anemia and the cause of pancytopenia, it is necessary to confirm or exclude deficiencies of iron (Fe), vitamin B12, and folate (B9), aplastic anaemia, blood loss, myelodysplastic syndrome, leukaemias, certain autoimmune and infectious diseases, bone marrow metastases, intoxications, and haemolysis of erythrocytes. The authors conclude that discordance frequently arises between cytopenic changes observed in peripheral venous CBC and findings from peripheral smear, reticulocyte enumeration by flow cytometry, instrumental studies and clinical manifestations. In such cases, reliable diagnostic decision‑making requires consideration of the strengths and limitations of each method and systematic integration of all arguments supporting or refuting the suspected diagnosis. Only this comprehensive approach increases diagnostic accuracy and provides a rational basis for selecting therapeutic strategy.