Aplastic Anemia - Essay

829 Words Aug 26th, 2012 4 Pages
Aplastic anemia is a condition where bone marrow does not produce sufficient new cells to replenish blood cells.[1] The condition, per its name, involves both aplasia and anemia. Typically, anemia refers to low red blood cell counts, but aplastic anemia patients have lower counts of all three blood cell types: red blood cells, white blood cells, and platelets, termed pancytopenia.
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[edit]Signs and symptoms * Anemia with malaise, pallor and associated symptoms such as palpitations * Thrombocytopenia (low platelet counts), leading to increased risk of hemorrhage, bruising and petechiae * Leukopenia (low white blood cell count), leading to increased risk of infection *
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[edit]Diagnosis
The condition needs to be differentiated from pure red cell aplasia. In aplastic anemia the patient has pancytopenia (i.e., anemia, neutropenia and thrombocytopenia) resulting in decrease of all formed elements. In contrast, pure red cell aplasia is characterized by reduction in red cells only. The diagnosis can only be confirmed on bone marrow examination. Before this procedure is undertaken, a patient will generally have had other blood tests to find diagnostic clues, including a complete blood count (CBC), renal function and electrolytes, liver enzymes, thyroidfunction tests, vitamin B12 and folic acid levels.
Following tests aid in determining differential diagnosis for aplastic anemia: 1. Bone marrow aspirate and biopsy: to rule out other causes of pancytopenia (i.e. neoplastic infiltration or significant myelofibrosis). 2. History of iatrogenic exposure to cytotoxic chemotherapy: can cause transient bone marrow suppression 3. X-rays, computed tomography (CT) scans, or ultrasound imaging tests: enlarged lymph nodes (sign of lymphoma), kidneys and bones in arms and hands (abnormal in Fanconi anemia) 4. Chest X-ray: infections 5. Liver tests: liver diseases 6. Viral studies: viral infections 7. Vitamin B12 and folate levels: vitamin deficiency 8. Blood tests for paroxysmal nocturnal hemoglobinuria

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