Aplastic Anemia

Aplastic Anemia

Aplastic Anemia is a clinical syndrome manifested as a deficiency of red cells, neutrophils, monocytes and platelets in the blood, and fatty replacement of the marrow with a near absence of hematopoietic precursor cells.

Aplastic anemia was first described by Paul Ehrlich in 1888 from an autopsy of a young pregnant woman who died of severe anemia and neutropenia. The name aplastic anemia subsequently was applied to this disease by the French hematologist Chauffard in 1904.

Symptoms

Symptoms and Signs of aplastic anemia include:

• Low red blood cell count (anemia)
• Low white blood cell count (neutropenia)
• Low platelet count (thrombocytopenia).
• Pale skin
• Fatigue
• Weakness
• Dizziness
• Headaches
• Rapid pulse
• Heart murmur
• Bruising and tiny areas of bleeding in the skin
• Abnormal bleeding from the gums, nose, vagina or gastrointestinal tract, or blood in the urine
• Infections
• Over time, severe heart issues may develop, such as arrhythmia (irregular heart beat), angina(chest pain), enlarged heart, and heart failure.

Severe AA is defined as pancytopenia accompanied by a markedly hypocellular marrow and two of the following three conditions :

1. A corrected reticulocyte count less than 1 percent
2. Fewer than 500/ µl granulocytes
3. Fewer than 20,000/ µl platelets.

Most of the AA cases are acquired. Fewer cases are the result of an inherited disorder such as Fanconi anemia.

List of Potential causes of Aplastic Anemia

Aplastic Anemia can be Acquired or Hereditary.  “Acquired” means you aren’t born with the condition, but you develop it. “Inherited” means your parents passed the gene for the condition on to you. Acquired aplastic anemia is more common, and sometimes it’s only temporary. Inherited aplastic anemia is rare.

I. Acquired Anemia

Acquired aplastic anemia can begin at any time in life. About 75 out of 100 cases of acquired aplastic anemia are idiopathic . This means they have no known cause. In the remaining cases, the cause can often be linked to:

1. Drugs

Chloramphenicol(antibiotic) is the most notorious drug documented to cause aplastic anemia. The drug is nitrobenzene derivative that commonly causes a brief, reversible suppression of the bone marrow in many exposed patients. Other drugs that induce aplastic anemia are :

1. Analgesic : Phenacetin, aspirin, salicylamide
2. Antiarthritics : Carbamazepine, felbamate, trimethadione
3. Antihistamine : Pencilamine, phenylbutazone
4. Antifungal : Quinacrine
5. Antiplatelet : Ticlopidine
6. Antithyroid : Carbimazole, sodium thiocyanate
7. Sedative : Lithium, methyprylon
8. Antibacterial : Acetazolamide