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Aplastic anemia

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Aplasia means improper development of a tissue, cell or any other part of the body. Aplastic anemia is a syndrome of the bone marrow marked by failure to produce blood cells, which include RBCs, WBCs and platelets. Deficiency in blood cells causes anemia.


Symptoms of aplastic anemia
  • Exhaustion and fatigue
  • Hemoglobin deficiency
  • Coldness in hands and feet
  • Fever and frequent infections
  • Bleeding gums, nose bleeds, blood in stool
  • Easy bruising
  • Uncontrolled bleeding from wounds


Causes of aplastic anemia

Damage to the stem cells of the bone marrow can be inherited or acquired, the latter being more common but temporary in nature. 

Some inherited disorders that lead to aplastic anemia are:
  • Diamond-Blackfan anemia
  • Shwachman-Diamond syndrome
  • Dyskeratosis congenital 
Acquired aplastic anemia occurs from:
  • Exposure to toxins like benzene, arsenic, insecticides, and pesticides
  • Side effects of radiation and chemotherapy
  • Side effects of certain antibiotics and rheumatoid arthritis medicines
  • Infections from viruses like Hepatitis, Epstein-Barr, cytomegalovirus, HIV
  • Also during pregnancy (temporary) due to autoimmune problem


How common is the disorder?

Aplastic anemia is a rare disorder. There are 2 - 12 new cases for every million people each year. Acquired aplastic anaemia is observed within the age group of 15 - 25 years. 


Complications of aplastic anemia

Reduction of blood cells can cause enlargement of the heart and heart failure. Untreated, severe aplastic anemia can also be fatal.


When to see a doctor?

Considering the complications of aplastic anemia, one should not delay medical check up on observing any of those aforementioned symptoms.


Diagnosis of aplastic anemia

Your doctor will first conduct a physical exam, check the characteristic symptoms of anemia and enquire about your medical history and probable chances of exposure to toxins. Since it’s a disorder of the bone marrow, typically there are two diagnostic tests that you need to undergo viz. blood tests and bone marrow biopsy. 

Complete blood count test: A sample of blood is collected from your body for quantitative analysis of RBC, WBC and platelets. Vitamin B 12, folate and iron levels are also checked in this test. Reduced levels of blood cells indicate the disorder.

Bone marrow biopsy: Sample cells from the bone marrow are also collected with a needle which is sent to the lab determine the count of blood cells.

Aplastic anemia is confirmed if the reports of CBC tests and bone marrow biospy reveal:
  • Haemoglobin <10 g/dL
  • Platelet count < 50 x 109/L
  • Neutrophil count <1.5 x 109/L 
Other tests specific to the underlying heath complications will also be conducted.


Treatment of asplastic anemia

The treatment depends on the severity of the syndrome. Primarily there are three lines of treatment: 

  • Blood transfusion is conducted to replace the blood cells i.e. red blood cells and platelets. WBCs cannot be replaced. The tenure of treatment could be short term or long term. It can be carried out on pregnant women as well. The complication of blood transfusion is – excessive transfusion of RBCs can lead to hemochromatosis (build up of too much iron in the body).
  • Bone marrow transplantation- This therapy involves replacing damaged cells of the bone marrow with healthy stem cells from a matching sibling donor.  The only downside is – probability of rejection of the graft. 
  • Immunosuppressive therapy is usually conducted on those who cannot undergo stem cell transplantation and is suffering from autoimmune disorders. Immune-suppressing drugs are prescribed to suppress the activity of immune cells responsible for causing aplasia. Aplastic anemia can recur after stopping the medicine. 
Bone marrow stimulants in conjunction with immune suppressive drugs may also be prescribed to boost the bone marrow to generate new blood cells. Since the immune system will be weakened, the patient may be additionally prescribed antibiotics and antiviral drugs. 

Written by: healthplus24.com team
Date last updated: January 24, 2014

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