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__NOTOC__
{{Aplastic anemia}}
{{Aplastic anemia}}
{{CMG}}
{{CMG}} {{shyam}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh13579@gmail.com]  {{N.F}}
==Overview==
==Overview==
[[Aplastic anemia]] is seen as a result of hypoplastic bone marrow causing [[pancytopenia]] ([[anemia]], [[neutropenia]], [[thrombocytopenia]]). The history and symptoms seen are secondary to these abnormalities.
[[Aplastic anemia]] is seen as a result of hypoplastic bone marrow causing [[pancytopenia]] ([[anemia]], [[neutropenia]], [[thrombocytopenia]]). The history and symptoms seen are secondary to these abnormalities.
==History==
The hallmark of aplastic anemia is past history of anemia (shortness of breath, [[dizziness]], [[headache]]s, or other signs and symptoms of [[anemia]]), exposure to certain toxins or medicines, [[radiation]] or [[chemotherapy]], infections or signs of [[infection]]s, such as [[fever]], [[bruises]] or tendency to [[bleed]] easily. Family history of [[anemia]] or other [[blood]] disorders should also be sought.
==Symptoms==
==Symptoms==
Lower than normal numbers of red blood cells, white blood cells, and platelets cause most of the signs and symptoms of aplastic anemia.
Decrease numbers of [[red blood cell]]s, [[white blood cell]]s, and [[platelet]]s cause most of the signs and symptoms of aplastic anemia.<ref name="pmid30055055">{{cite journal |vauthors=Shallis RM, Ahmad R, Zeidan AM |title=Aplastic anemia: etiology, molecular pathogenesis and emerging concepts |journal=Eur. J. Haematol. |volume= |issue= |pages= |date=July 2018 |pmid=30055055 |doi=10.1111/ejh.13153 |url=}}</ref>
===Red Blood Cells===
===Red Blood Cells===
* [[Fatigue]]
* [[Fatigue]]
* [[Shortness of breath]]
* [[Shortness of breath]]
* [[Dizziness]], especially when standing up
* [[Dizziness]]
* [[Headaches]]
* [[Headaches]]
* Coldness in hands or feet
* Coldness in hands or feet
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* [[Chest pain]]
* [[Chest pain]]
* Irregular heartbeats  
* Irregular heartbeats  
* symptoms suggestive of [[heart failure]] (edema, abdominal distension)
* symptoms suggestive of [[heart failure]] [[Edema|(edema]], abdominal distension)
===White Blood Cells===
===White Blood Cells===
White blood cells help fight infections. Symptoms of a low white blood cell count include
* [[Fever]]
* [[Fever]]
* Frequent infections that can be severe
* Frequent infections
* Flu-like illnesses  
* Flu-like illnesses
 
===Platelets===
===Platelets===
Platelets stick together to seal small cuts or breaks on blood vessel walls and stop bleeding.
* People who have low platelet counts tend to bruise and bleed easily
* [[bruise|Bruises]]
* Common types of bleeding associated with a low platelet count include nosebleeds, bleeding gums, pinpoint red spots on the skin, and blood in the stool.
* [[Epistaxis]]
* Women also may have heavy menstrual bleeding.
* [[Mucosal bleeding]]
* Pinpoint red spots on [[skin]] and in the [[stool]]
* [[Menorrhagia]]
 
===Other Symptoms===
===Other Symptoms===
Aplastic anemia can cause signs and symptoms that aren't directly related to low blood cell counts. Examples include  
Aplastic anemia can cause signs and symptoms that aren't directly related to low blood cell counts. Examples include:
* Nausea  
* [[Nausea]]
* Skin rashes.
* [[Skin rashes]]
 
===Paroxysmal Nocturnal Hemoglobinuria===
===Paroxysmal Nocturnal Hemoglobinuria===
* Some people who have aplastic anemia have a red blood cell disorder called paroxysmal nocturnal hemoglobinuria, or PNH. Most people who have PNH don't have any signs or symptoms.
Some people who have aplastic anemia have a [[red blood cell]] disorder called [[paroxysmal nocturnal hemoglobinuria]], or PNH. Most people who have [[PNH]] don't have any signs or symptoms. In people who have aplastic anemia and [[PNH]], either condition can develop first. If symptoms do occur, they may include:
If symptoms do occur, they may include:
* [[Shortness of breath]]
* Shortness of breath
* [[Swelling]] or pain in the [[abdomen]] or swelling in the legs caused by [[blood clots]]
* Swelling or pain in the abdomen or swelling in the legs caused by blood clots
* [[Blood]] in the [[urine]]
* Blood in the urine
* [[Headaches]]
* Headaches
* [[Jaundice]]
* Jaundice  
In people who have aplastic anemia and PNH, either condition can develop first.


==Diagnosis and management of aplastic anemia <ref name="pmid19673883">{{cite journal| author=Marsh JC, Ball SE, Cavenagh J, Darbyshire P, Dokal I, Gordon-Smith EC et al.| title=Guidelines for the diagnosis and management of aplastic anaemia. | journal=Br J Haematol | year= 2009 | volume= 147 | issue= 1 | pages= 43-70 | pmid=19673883 | doi=10.1111/j.1365-2141.2009.07842.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19673883  }} </ref> (DONOT EDIT)==
==Diagnosis and management of aplastic anemia <ref name="pmid19673883">{{cite journal| author=Marsh JC, Ball SE, Cavenagh J, Darbyshire P, Dokal I, Gordon-Smith EC et al.| title=Guidelines for the diagnosis and management of aplastic anaemia. | journal=Br J Haematol | year= 2009 | volume= 147 | issue= 1 | pages= 43-70 | pmid=19673883 | doi=10.1111/j.1365-2141.2009.07842.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19673883  }} </ref> (DONOT EDIT)==
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* Patients presenting with [[aplastic anaemia]] should be assessed to:
* Patients presenting with [[aplastic anaemia]] should be assessed to:
** Confirm the diagnosis and exclude other possible causes of [[pancytopenia]] with hypocellular [[bone marrow]]
** Confirm the diagnosis and exclude other possible causes of [[pancytopenia]] with hypocellular [[bone marrow]]
** Classify the disease severity using standard blood and bone marrow criteria
** Classify the disease severity using standard [[blood]] and [[bone marrow]] criteria
** Document the presence of associated [[paroxysmal nocturnal haemoglobinuria]] (PNH) and cytogenetic clones
** Document the presence of associated [[paroxysmal nocturnal haemoglobinuria]] (PNH) and cytogenetic clones
** Exclude a possible late onset inherited bone marrow failure disorder
** Exclude a possible late onset inherited bone marrow failure disorder
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{{reflist|2}}
{{reflist|2}}


[[Category:Needs content]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Autoimmune diseases]]
[[Category:Autoimmune diseases]]

Latest revision as of 02:14, 3 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.D. [3] Nazia Fuad M.D.

Overview

Aplastic anemia is seen as a result of hypoplastic bone marrow causing pancytopenia (anemia, neutropenia, thrombocytopenia). The history and symptoms seen are secondary to these abnormalities.

History

The hallmark of aplastic anemia is past history of anemia (shortness of breath, dizziness, headaches, or other signs and symptoms of anemia), exposure to certain toxins or medicines, radiation or chemotherapy, infections or signs of infections, such as fever, bruises or tendency to bleed easily. Family history of anemia or other blood disorders should also be sought.

Symptoms

Decrease numbers of red blood cells, white blood cells, and platelets cause most of the signs and symptoms of aplastic anemia.[1]

Red Blood Cells

White Blood Cells

  • Fever
  • Frequent infections
  • Flu-like illnesses

Platelets

Other Symptoms

Aplastic anemia can cause signs and symptoms that aren't directly related to low blood cell counts. Examples include:

Paroxysmal Nocturnal Hemoglobinuria

Some people who have aplastic anemia have a red blood cell disorder called paroxysmal nocturnal hemoglobinuria, or PNH. Most people who have PNH don't have any signs or symptoms. In people who have aplastic anemia and PNH, either condition can develop first. If symptoms do occur, they may include:

Diagnosis and management of aplastic anemia [2] (DONOT EDIT)

Diagnosis and Evaluation of aplastic anemia

  • Careful history and clinical examination
  • Detailed drug and occupational exposure history
  • Patients presenting with aplastic anaemia should be assessed to:
  • Multidisciplinary approach
  • Referral to specialist if necessary

References

  1. Shallis RM, Ahmad R, Zeidan AM (July 2018). "Aplastic anemia: etiology, molecular pathogenesis and emerging concepts". Eur. J. Haematol. doi:10.1111/ejh.13153. PMID 30055055.
  2. Marsh JC, Ball SE, Cavenagh J, Darbyshire P, Dokal I, Gordon-Smith EC; et al. (2009). "Guidelines for the diagnosis and management of aplastic anaemia". Br J Haematol. 147 (1): 43–70. doi:10.1111/j.1365-2141.2009.07842.x. PMID 19673883.