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Aplastic anemia – causes, symptoms, treatment

Aplastic anemia is a severe disease characterized by pancytopenia (decreased red blood cells, leukocytes, and platelets well below physiological values) associated with fewer cells in bone marrow.

Causes of aplastic anemia

In terms of etiology, the condition may be acquired or hereditary. Acquired aplastic anemia may occur after the action of chemicals (insecticides, benzene), viruses (Epstein Barr virus, cytomegalovirus), ionizing radiation, drugs (chloramphenicol, gold salts, carbamazepine, phenytoin, Mezantoin, D-penicillamine).

Hereditary aplastic anemia can occur in conditions such as congenital Diskeratosis, Schwachman-Diamond syndrome, Fanconi anemia, but may be idiopathic (unknown cause).

Aplastic anemia symptoms

The clinical picture is severe and is associated with manifestations caused by decrease of figurative elements of blood (red cells, platelets, leukocytes). Such decrease in red blood cells will cause the following symptoms: fatigue, headache, dyspnoea exertional, palpitations, decreased platelets will cause a series of events such as epistaxis bleeding, bruising from minimum trauma, gums bleeding, metrorrhagia (uterine bleeding produced during the menstruation), and decreased leukocytes have a clinical response: recurrent infections.


Investigations necessary to support the diagnosis are the examination of peripheral blood and bone marrow.

Peripheral blood examination shows the following changes:

– Erythrocytes-low;

– Platelet-low;

– White blood cells-low;

– Reticulocytes-low;

Bone marrow examination reveals a severe lack of bone marrow cell. This occurs due to replacement of hematopoietic parenchyma with fat tissue.

Aplastic anemia complications

During the evolution of the disease may occur a number of complications that worsen the prognosis. Complications that occur can be acute or chronic.

Of acute complications, the most significant are:

– Bleeding complications, GI bleeding, uterine bleeding, epistaxis;

– Infectious complications of respiratory tract, skin;

– Malignant complications, myelodysplasia, acute leukemia;

Chronic complications are arising from repeated transfusions are represented by hemochromatosis. Over time, can cause cirrhosis and may affect the level of pancreatic insulin secretion of islets of Langerhans.

Aplastic anemia treatment

In the treatment of aplastic anemia, the only curative effect is bone marrow transplantation which is the major indication in people younger than 40 years.

Immunosuppressants may be used as globulin antitimocytes (GAT) or cyclosporin A but not curative.

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