Definition
- Aplastic anemia is a pancytopenia resulting from hypoplasia of the bone marrow!
Etiology
Table 22.2 Causes of aplastic anaemia.
EBV, Epstein–Barr virus.
Classification
- Primary- develops without evidence of underlying disease
- Secondary- develops due to another pathological process occurring in the body
Pathogenesis
- The underlying defect in all cases appears to be a substantial reduction in the number of haemopoietic pluripotential stem cells, and a fault in the remaining stem cells or an immune reaction against them
Symptoms
- Onset is at any age, with peak incidence around 10-25 and over 60 year olds
- Sudden onset febrile illness
- Bruising
- Bleeding gums
- Epistaxis
- Menorrhagia
- Retinal hemorrhage may impair vision
- Frequent infections of mouth and throat
Diagnosis
- CBC- there must be at least 2 of the following:
- Anemia (normochromic, normocytic or macrocytic)
- Reticulocyte count is very low in relation to the degree of anemia
- Neutropenia
- Thrombocytopenia
- No abnormal cells in peripheral blood
- Bone marrow shows hypoplasia with loss of hematopoetic tissue and replacement by fat
- Bone marrow biopsy:
- Hypocellular and devoid of marrow progenitors