全血细胞减少症是所有外周血细胞系中细胞数量的减少，与贫血、癌症、化疗、感染和营养缺乏有关。然而，全血细胞减少症并发脑病的情况很少见，且尚未得到充分研究。我们提出一例全血细胞减少症并发代谢性脑病的病例。一名 81 岁女性患者因两周疲劳加重和嗜睡而到急诊科就诊。患者在初次体检期间难以保持清醒，其实验室结果显示全血细胞减少、高肌酸血症、高钠血症、高镁血症和碱血症。她被送入楼层，被诊断患有代谢性脑病和急性肾损伤，并接受了停药、液体复苏和补充电解质的治疗。她还接受了全血细胞减少症、铁替代和红细胞输注治疗的全面检查。在她的代谢性脑病得到解决后，她出院了，并计划进行血液学/肿瘤学随访，以了解稳定但未解决的全血细胞减少症。我们推测患者的代谢性脑病很可能是由于急性肾损伤引起的尿毒症或脱水所致。我们进一步假设细小病毒 B19 和骨髓增生异常综合征是全血细胞减少症的可能病因。我们的案例强调了密切监测服用钠-葡萄糖协同转运蛋白 2 (SGLT-2) 抑制剂和袢利尿剂的患者对于脱水和随后的器官衰竭的重要性。版权所有 © 2024，Zou 等人。

Pancytopenia is a decrease in the number of cells in all peripheral blood cell lines and has been associated with anemias, cancers, chemotherapy, infections, and nutritional deficiencies. However, pancytopenia concurrent with encephalopathy is rare and not well-studied. We present a case of pancytopenia concurrent with metabolic encephalopathy. An 81-year-old female patient presented to the emergency department for two weeks of increased fatigue and hypersomnolence. The patient had trouble staying awake during the initial physical exam, and her laboratory results were significant for pancytopenia, hypercreatinemia, hypernatremia, hypermagnesemia, and alkalemia. She was admitted to the floor, diagnosed with metabolic encephalopathy and acute kidney injury, and treated with medication withholding, fluid resuscitation, and electrolyte repletion. She also received a comprehensive workup for pancytopenia, iron replacement, and red blood cell transfusion therapy. After her metabolic encephalopathy was resolved, she was discharged with plans to follow up with hematology/oncology for stable but unresolved pancytopenia. We hypothesize that the patient's metabolic encephalopathy was likely due to acute kidney injury-induced uremia or dehydration. We further hypothesize that parvovirus B19 and myelodysplastic syndrome are possible etiologies for pancytopenia. Our case highlights the importance of closely monitoring patients taking Sodium-glucose co-transporter-2 (SGLT-2) inhibitors and loop diuretics for dehydration and subsequent organ failure.Copyright © 2024, Zou et al.