Multiple choice

Pancytopenia with cellular bone marrow is seen in all, except

  1. PNH

  2. megaloblastic anaemia

  3. myelodysplastic anaemia

  4. congenital dyserythropoietic anaemia

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D Correct answer
Explanation

Cellular marrow means the bone marrow is hypercellular, ruling out aplastic causes. PNH causes pancytopenia due to intravascular hemolysis with cellular marrow. Megaloblastic anemia shows ineffective erythropoiesis with cellular marrow. Myelodysplastic syndrome presents with pancytopenia and hypercellular marrow. Congenital dyserythropoietic anemia primarily affects erythropoiesis with macrocytic anemia but does not typically cause pancytopenia - it is the exception.

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