Diagnosis of Aplastic Anemia
Diagnosis is based on History, physical examination and laboratory tests.
1. History
Here the doctor may ask questions whether you’ve had anemia or have been exposed to toxins, medicines, radiations or chemotherapy, or have had infections or signs of infections.
2. Physical Exam
Your doctor will do a physical exam to check for signs of aplastic anemia. The exam may include checking for pale or yellowish skin and signs of bleeding or infection. Your doctor may listen to your heart and lungs for abnormal heartbeats and breathing sounds. He or she also may feel your abdomen to check the size of your liver and feel your legs for swelling.
3. Laboratory Studies
Laboratory studies include :
- Complete blood count
- Reticulocyte count
- Examination of blood film
- Marrow aspiration and biopsy
- Red cell hemoglobin F content and DNA stability test as markers of Fanconi anemia
- Direct and Indirect Coombs test to rule out immune cytopenia
- Liver function tests to assess evidence of recent hepatitis virus exposure.
Treatment
1. Blood Transfusion
Blood transfusions aren’t a cure for aplastic anemia. But they do relieve signs and symptoms by providing blood cells that your bone marrow isn’t producing. A transfusion may include red blood cells or platelets. Transfusions of red blood cells raise red blood cell counts. This helps relieve anemia and fatigue. Transfusions of platelets help prevent excessive bleeding.
2. Hematopoietic Stem cell transplantation (Bone marrow Transplant)
The major curative approach is stem cell transplant from a histocompatible sibling. If a donor is found, your diseased bone marrow is first depleted with radiation or chemotherapy. Healthy stem cells from the donor are filtered from the blood. The healthy stem cells are injected intravenously into your bloodstream, where they migrate to the bone marrow cavities and begin generating new blood cells. The procedure requires a lengthy hospital stay. After the transplant, you’ll receive drugs to help prevent rejection of the donated stem cells.
3. Immunosuppressive Therapy
For people who can’t undergo a bone marrow transplant or for those whose aplastic anemia may be due to an autoimmune disorder, treatment may involve drugs that alter or suppress the immune system (immunosuppressants). Drugs like cyclosporine, High dose glucocorticoids and cyclophosphamide are used as immunosuppressants.
Sources
1. Williams Hematology by Kenneth Kaushansky (Author), Marshall A. Lichtman (Author), Josef Prchal (Author), Marcel M. Levi (Author), Oliver W Press (Author), Linda J Burns (Author), Michael Caligiuri (Author)
2. Hematology for the Medical Student edited by Alvin H. Schmaier, Lilli M. Petruzzelli