Aplastic Anemia

Question 1

Definition

Answer 1

Bone marrow fails to produce enough RBCs, WBCs or platelets
Can result in arrythmias, cardiomegaly, failure, infections and bleeding
Can be acquired or inherited
About 500-1000 people in the US are diagnosed with it- 2-3 times more common in Asian countries
In more than 50% of those with the disorder etiology is unknown

Question 2

Causes

Answer 2

Acquired is more common than inherited
Causes can be:
pesticides, arsenic, benzene
radiation & chemotherapy
Infectious disease- EBV, CMG, parvovirus & HIV
Autoimmune disorders- lupus and RA
Inherited conditions can damage the stem cells/bone marrow- Fanconi anemia, Shwachman-Diamond syndrome, Diamond-Blackfan anemia

Question 3

Signs & Symptoms

Answer 3

Fatigue, Shortness of breath, dizziness, headache, cold extremities, pale skin and mucous membranes, chest pain, frequent infections, bruising and other bleeding issues (GI, excessive menstrual flow, gums bleeding) purpura, nausea, hematuria
Can lead to heart failure, heart murmurs, cardiomegaly

Question 4

Dx

Answer 4

CBC
Retic count
Bone marrow testing
Workup may include LFT, B12 and folate, CXR, U/S ?
Referral, referral, referral

Question 5

Tx

Answer 5

Mild to moderate- watchful vigilance
Blood transfusions
Stem cell transplants
Erythropoietin to stimulate bone marrow production of RBCs
Immuno suppressive drugs