Aplastic anemia is a potentially severe form of anemia. Typical anemia describes a decrease in red blood cells caused by a variety of reasons. Aplastic anemia is a decrease in levels in the blood of white and red blood cells and platelets caused by pathology in the bone marrow.
The symptoms for Aplastic anemia are extreme tiredness and pallor (a pale complexion, nose bleeds, unusual bruising and a skin rash. Aplastic anemia can develop suddenly or gradually over a period of a few weeks. Symptoms that also are present with Aplastic anemia are bleeding gums, excessive bleeding from minor cuts, rapid heart rate and shortness of breath during physical activity.
Diagnosis of aplastic anemia is confirmed with blood tests and a bone marrow biopsy. A blood test, in which the red and white blood cell and platelet levels are all low, will initiate the investigation as to whether or not the patient has Aplastic anemia. Most blood disorders affect only one level of one type of blood cells. Aplastic anemia’s primary marker is that all three types of blood cell production are affected.
The next step for diagnosis is a bone marrow biopsy. A bone marrow biopsy is performed with sedation of the patient for comfort. The procedure involves removal of bone marrow from a larger bone in the patient’s body – usually the hipbone. The marrow is microscopically examined for the markers of aplastic anemia. A patient who has aplastic anemia will have fewer cells in the marrow than a healthy patient. The cells will normal, as opposed to leukemia which will show abnormal blood cells in the marrow.
A patient with aplastic anemia is usually referred to a hematologist – a doctor who specializes in blood disorders or to a aplastic anemia treatment clinic or center. Another step in evaluation and diagnosis is to determine what caused the aplastic anemia.
Bone marrow is a red spongy material inside the hollow portion of many bones in the body. Stems cells in bone marrow create white and red blood cells and platelets. The body continuously produces blood cells to replace cells that naturally die off or are used and absorbed by the body. Red blood cells live in the body for four months, white for a day and platelets for up to a week.
A healthy bone marrow will produce the correct numbers and balance of blood cell levels to maintain the health of the individual. Damage to the bone marrow can cause aplastic anemia. But what damages bone marrow? Bone marrow can be damaged through a number of environmental factors such as: high radiation, chemotherapy does that kill off cancer and unfortunately stem cells, toxic chemical exposures such as pesticides and insecticides. Certain drugs can also damage the bone marrow – antibiotics and illegal drugs can cause a secondary form of aplastic anemia.
Some disorders and conditions can also cause aplastic anemia. They are autoimmune disorders such as lupus, a viral affection can attach bone marrow and sometimes, though extremely rare, during pregnancy. The pregnancy may trigger a body to attack bone marrow. Bone marrow diseases can also cause aplastic anemia. In half of all cases doctors are not able to pinpoint the exact cause of aplastic anemia. In this case, aplastic anemia is referred to as idiopathic aplastic anemia.
* Bone marrow diseases. Diseases that affect bone marrow can eventually lead to an added diagnosis of aplastic anemia.
* Unknown factors. In about half of cases, doctors aren't able to identify the cause of aplastic anemia. This is called idiopathic aplastic anemia.
Thirty percent of patients with aplastic anemia also have a co-morbidity of paroxysmal nocturnal hemoglobinuria – a rare disorder in which marrow cells destroy red blood cells and produce defective platelets.
Aplastic anemia can have mild, moderate or severe expressions in the patient. The severe form of aplastic anemia requires immediate hospitalization and is life threatening.
Mild and moderate forms of aplastic anemia do not commonly require hospitalization for treatment. Treatment for aplastic anemia can include blood transfusions, which are not a cure, but provide relief of symptoms. Blood transfusions can consist of platelets only, red blood cells and white blood cells. Patients can have an unlimited number of blood cell transfusion, but some complications can occur – a red blood cell transfusion contains iron that builds up in the body. High levels of iron need to be treated. Some transfusions also may contain viruses or infections. Currently the screening process for blood donation ensures the safety of blood – more than it has been in the past.
When aplastic anemia is caused by an autoimmune disorder, drugs that change or retrain the immune system are prescribed. Steroids may be given with immunosuppressant drugs to relieve side effects. There is a possibility, unfortunately that the aplastic anemia may return after this course of treatment.
A bone marrow transplant replaces the defective bone marrow with healthy marrow form a matching donor. It is possibly the only solution for patients who have severe aplastic anemia. In eighty percent of cases, aplastic anemia does not return after a bone marrow transplant.
Antibiotics can be used to help the body fight infection, since the normal fighters – white blood cells are greatly decreased.
Aplastic anemia caused by radiation, chemotherapy and pregnancy-related anemia usually clears up on its own – after the end of treatment and completion of the pregnancy.
Aplastic anemia can be fatal, if treatment does not work. There are experimental treatments currently being investigated – they use growth factor drugs, male hormone therapy and a peripheral stem cell transplants. These treatments are not yet widely available, since they are under investigation.
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