<unk>  must be differentiated from pure red cell aplasia. In<unk> , the patient has pancytopenia (i.e., also leukopenia and thrombocytopenia) resulting in a decrease of all formed elements. In contrast, pure red cell aplasia is characterized by a reduction in red cells only. The diagnosis can only be confirmed with a bone marrow examination. Before this procedure is undertaken, a patient will generally have had other blood tests to find diagnostic clues, including a complete blood count, renal function and electrolytes, liver enzymes, thyroid function tests, vitamin B12 and folic acid levels. Tests that may aid in determining an etiology for<unk>  include: # History of iatrogenic exposure to cytotoxic chemotherapy: transient bone marrow suppression # Vitamin B12 and folate levels: vitamin deficiency # Liver tests: liver diseases # Viral studies: viral infections # Chest X-ray: infections # X-rays, computed tomography (CT) scans, or ultrasound imaging tests: enlarged lymph nodes (sign of lymphoma), kidneys, and bones in arms and hands (abnormal in Fanconi anemia) # Antibody test: immune competency # Blood tests for paroxysmal nocturnal hemoglobinuria # Bone marrow aspirate and biopsy: to rule out other causes of pancytopenia (i.e., neoplastic infiltration or significant myelofibrosis).
Aplastic anemia
Acute lymphoblastic leukemia
Refractory anemia with excess of blasts
Polycythemia vera
Myelodysplastic syndrome
Myomatous erythrocytosis syndrome
Essential thrombocythemia
Refractory cytopenia of childhood