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{{Aplastic anemia}}
{{Aplastic anemia}}
{{CMG}}
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh@perfuse.org]
==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.

Revision as of 15:27, 24 September 2012

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

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

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

Lower than normal numbers of red blood cells, white blood cells, and platelets cause most of the signs and symptoms of aplastic anemia.

Red Blood Cells

White Blood Cells

White blood cells help fight infections. Symptoms of a low white blood cell count include

  • Fever
  • Frequent infections that can be severe
  • Flu-like illnesses

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
  • 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.
  • Women also may have heavy menstrual bleeding.

Other Symptoms

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

  • Nausea
  • Skin rashes.

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.

If symptoms do occur, they may include:

  • Shortness of breath
  • Swelling or pain in the abdomen or swelling in the legs caused by blood clots
  • Blood in the urine
  • Headaches
  • Jaundice

In people who have aplastic anemia and PNH, either condition can develop first.

Diagnosis and management of aplastic anemia [1] (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:
    • 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
    • Document the presence of associated paroxysmal nocturnal haemoglobinuria (PNH) and cytogenetic clones
    • Exclude a possible late onset inherited bone marrow failure disorder
  • Multidisciplinary approach
  • Referral to specialist if necessary

References

  1. 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.