BOF: General (Aplastic Anaemia)

Which ONE of the following is LEAST likely to be causal if found to be positive in assessing for the underlying cause of PANCYTOPENIA?

a) Absent CD59 and CD55 labelled cells by flow cytometry

b) Clonal lymphocytosis expressing CD11c, CD25 and CD123

c) Hepatitis B core antibody positive viral serology

d) Human immunodeficiency virus B positive viral serology

e) Positive antinuclear and anti-dsDNA antbodies

Answer:

d) Human immunodeficiency virus B positive viral serology

Explanation:

HIV infection can be associated with isolated cytopenias but is rarely associated with a pancytopenia and another underlying cause should be found. Systemic lupus erythrematosis (SLE), paroxysmal nocturnal haemoglobinuria (absent PIG-linked glycoproteins CD55 and 59), viral hepatitis (although more commonly sero-negative for hepatitis B and C viruses) and hairy cell leukaemia are all recognised causes, although rare.

Reference:

Killick SB, Bown N, Cavenagh J et al. British Committee for Standards in Haematology approved document: Guidelines for the Diagnosis and Management of Adult Aplastic Anaemia (2015) Br J Haematol. 2016 Jan;172(2):187-207.