Aplastic anemia history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.D. [3] Nazia Fuad M.D.

Overview

Aplastic anemia is seen as a result of hypoplastic bone marrow causing pancytopenia (anemia, neutropenia, thrombocytopenia). The history and symptoms seen are secondary to these abnormalities.

History

The hallmark of aplastic anemia is past history of anemia (shortness of breath, dizziness, headaches, or other signs and symptoms of anemia), exposure to certain toxins or medicines, radiation or chemotherapy, infections or signs of infections, such as fever, bruises or tendency to bleed easily. Family history of anemia or other blood disorders should also be sought.

Symptoms

Decrease numbers of red blood cells, white blood cells, and platelets cause most of the signs and symptoms of aplastic anemia.

Red Blood Cells

• Fatigue
• Shortness of breath
• Dizziness
• Headaches
• Coldness in hands or feet
• Pale skin
• Chest pain
• Irregular heartbeats
• symptoms suggestive of heart failure (edema, abdominal distension)

White Blood Cells

• Fever
• Frequent infections
• Flu-like illnesses

Platelets

• Bruises
• Epistaxis
• Mucosal bleeding
• Pinpoint red spots on skin and in the stool
• Menorrhagia

Other Symptoms

Aplastic anemia can cause signs and symptoms that aren't directly related to low blood cell counts. Examples include:

• Nausea
• Skin rashes

Paroxysmal Nocturnal Hemoglobinuria

Some people who have aplastic anemia have a red blood cell disorder called paroxysmal nocturnal hemoglobinuria, or PNH. Most people who have PNH don't have any signs or symptoms. In people who have aplastic anemia and PNH, either condition can develop first. If symptoms do occur, they may include:

• Shortness of breath
• Swelling or pain in the abdomen or swelling in the legs caused by blood clots
• Blood in the urine
• Headaches
• Jaundice

Diagnosis and management of aplastic anemia (DONOT EDIT)

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Diagnosis and Evaluation of aplastic anemia Careful history and clinical examination Detailed drug and occupational exposure history Patients presenting with aplastic anaemia should be assessed to: Confirm the diagnosis and exclude other possible causes of pancytopenia with hypocellular bone marrow Classify the disease severity using standard blood and bone marrow criteria Document the presence of associated paroxysmal nocturnal haemoglobinuria (PNH) and cytogenetic clones Exclude a possible late onset inherited bone marrow failure disorder Multidisciplinary approach Referral to specialist if necessary

”