Aplastic Anemia

What is aplastic anemia?

Aplastic anemia occurs when the bone marrow produces too few of all three types of blood cells: red blood cells, white blood cells, and platelets. A reduced number of red blood cells causes hemoglobin to drop. A reduced number of white blood cells makes the patient susceptible to infection. And, a reduced number of platelets causes the blood not to clot the way it should.

What causes aplastic anemia?

Aplastic anemia has multiple causes. Some of these causes are idiopathic, meaning they occur sporadically for no known reason. Other causes are secondary, resulting from a previous illness or disorder. Acquired causes, however, may include the following:

  • History of specific infectious diseases, such as hepatitis, Epstein-Barr virus (EBV), cytomegalovirus (CMV), parvovirus B19, or HIV

  • History of taking certain medications, such as antibiotics and anticonvulsants

  • Exposure to certain toxins, such as heavy metals

  • Exposure to radiation

  • History of an autoimmune disease, such as lupus

  • Inherited condition

What are the symptoms of aplastic anemia?

The following are the most common symptoms of aplastic anemia. However, each individual may experience symptoms differently. Symptoms may include:

  • Headache

  • Dizziness

  • Nausea

  • Shortness of breath

  • Bruising

  • Lack of energy or tiring easily (fatigue)

  • Abnormal paleness or lack of color of the skin

  • Blood in stool

  • Nosebleeds

  • Bleeding gums

  • Fevers

  • Sinus tenderness

  • Enlarged liver or spleen

  • Oral thrush (white patches on a red, moist, swollen surface, occurring anywhere in the mouth)

The symptoms of aplastic anemia may resemble other blood disorders or medical problems. Always consult your doctor for a diagnosis.

How is aplastic anemia diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for aplastic anemia may include:

  • Blood tests. These may include blood chemistries, evaluation of liver and kidney functions, and genetic studies.

  • Bone marrow aspiration and/or biopsy. A procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.

Treatment for aplastic anemia

Specific treatment for aplastic anemia will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Aplastic anemia is a serious illness, and treatment usually depends on the underlying cause. For certain causes, recovery can be expected after treatment; however, relapses can occur. To treat the low blood counts, initially treatment is usually supportive, meaning that it is necessary to treat the symptoms, but not possible to cure the disease. Supportive therapy may include:

  • Blood transfusion (both red blood cells and platelets)

  • Preventative antibiotic therapy

  • Meticulous hand-washing

  • Special care to food preparation (such as only eating well-cooked foods)

  • Avoiding construction sites, which may be a source of certain fungi

  • Medications (to stimulate the bone marrow to produce cells)

  • Immunosuppressive therapy

  • Hormone therapy

In the appropriate patient, bone marrow transplantation may cure aplastic anemia. 

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