Table 2.

Initial evaluation of adolescents and young adults presenting with cytopenias

Patient history	Duration of cytopenias (are pediatric records available?)
	Medications (prescribed and over-the-counter supplements)
	Immunization records
	Exposures
	Transfusions
Family history	Constitutional abnormalities
	Malignancies
Physical examination	Height (in context of mean parental height)
	Limb abnormalities
	Skin and nail abnormalities (café-au-lait spots, nail dystrophy, pale patches)
Laboratory	Peripheral blood
	β-Human chorionic gonadotropin (consider even if intercourse is not explicitly stated)
	Complete blood count with differential
	Reticulocyte counts
	Chemistries
	Transaminases and bilirubin
	Hepatitis serologies
	Fluorescent aerolysin assay for paroxysmal nocturnal hemoglobinuria
	Chromosome breakage tests
	Telomere length and mutational analysis (if DKC suspected)
	Bone marrow
	Aspirate and biopsy
	Flow cytometry (including quantitative CD34)
	Cytogenetics