Aplastic Anemia

Also known as
Hypoplastic anemia, refractory anemia or pan-myelo-phthisis

Description
* Of the many components that make up the cells --e.g., red blood cells (carry oxygen), platelets (stop bleeding), white blood cells (fight infection) -- all are made in the bone marrow. The bone marrow is contained in the long and pelvic bones of the body. When the bone marrow is damaged or destroyed, the result is a lack of production of the cellular productions of blood -- resulting in aplastic anemia. Toxins, radiation, cancer chemotherapy, and medications are the main causes of this condition.



Symptoms
* Weakness
* Fatigue
* Shortness of breath
* Infections
* Nosebleeds
* Occult blood loss from the rectum
* Gastrointestinal bleeding
* Heavy menstrual bleeding
* Bleeding in gums
* Bleeding under skin

Cause
* Idiopathic (probably autoimmune -- the body mistakenly attacks the bone marrow)
* Diseases:

1. Systemic Lupus Erythematosus
2. Post-hepatitis
3. Congenital (Fanconi's anemia)
4. Paroxysmal nocturnal hemoglobinuria
5. AIDS
6. Viral hepatitis

* Toxins:

1. Benzene
2. Toluene
3. Insecticides

* Medications:

1. Chloramphenicol
2. Phenylbutazone
3. Gold Salts
4. Sulfonamides
5. Phenytoin (Dilantin)
6. Carbamazepine (Tegretol)
7. Quinacrine
8. Tolbutamide

* Cancer Chemotherapy
* Radiation therapy
* Pregnancy
* Some forms may be associated with thymomas (the types that only affect red blood cells)



How The Diagnosis Is Made
* Examination:

1. Pale
2. Red/purple blotchy rash
3. Fine "red dot" rash
4. Enlarged liver
5. Enlarged spleen
6. Swollen lymph glands
7. Bone tenderness

* Laboratories:

1. Complete blood count shows anemia, decreased white blood cell count, decreased platelets
2. There may be blood in stool or urinalysis.
3. HLA testing -- a genetic marker is evident

* Tests:

- Bone marrow biopsy

Treatment
* Supportive therapy such as oxygen may be needed
* Blood Transfusions
* Platelet Transfusions
* Bone Marrow Transplantation
* Antithymocyte Globulin (suppresses immune system to treat autoimmune cause, i.e., stops the body from mistakenly attacking the bone marrow).
* Cyclosporin (used with Antithymocyte Globulin)
* Cyclophosphamide and predisone are also used in some cases.
* G-CSF & GM-CSF (stimulate white blood cell production)
* Androgens (only works in a few cases)

If You Suspect This Condition
* You must seek immediate medical attention. If not treated, there is an 80% death rate in 3 months.

Similar Conditions
* Myelodysplasia
* Acute Leukemia
* Myelofibrosis
* Lymphoma
* Multiple Myeloma
* Hairy cell leukemia
* B12 deficiency
* Folic Acid Deficiency

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