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__NOTOC__
{{Aplastic anemia}}
{{Aplastic anemia}}
{{CMG}}
{{CMG}} {{shyam}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh13579@gmail.com]  {{N.F}}
==Overview==
==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.
[[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]], [[headache]]s, or other signs and symptoms of [[anemia]]), exposure to certain toxins or medicines, [[radiation]] or [[chemotherapy]], infections or signs of [[infection]]s, such as [[fever]], [[bruises]] or tendency to [[bleed]] easily. Family history of [[anemia]] or other [[blood]] disorders should also be sought.
==Symptoms==
==Symptoms==
Lower than normal numbers of red blood cells, white blood cells, and platelets cause most of the signs and symptoms of aplastic anemia.
Decrease numbers of [[red blood cell]]s, [[white blood cell]]s, and [[platelet]]s cause most of the signs and symptoms of aplastic anemia.<ref name="pmid30055055">{{cite journal |vauthors=Shallis RM, Ahmad R, Zeidan AM |title=Aplastic anemia: etiology, molecular pathogenesis and emerging concepts |journal=Eur. J. Haematol. |volume= |issue= |pages= |date=July 2018 |pmid=30055055 |doi=10.1111/ejh.13153 |url=}}</ref>
===Red Blood Cells===
===Red Blood Cells===
The most common symptom of a low red blood cell count is fatigue (tiredness). A lack of hemoglobin in the blood causes fatigue. Hemoglobin is an iron-rich protein in red blood cells. It helps carry oxygen to the body.
* [[Fatigue]]
* [[Shortness of breath]]
* [[Dizziness]]
* [[Headaches]]
* Coldness in hands or feet
* Pale skin
* [[Chest pain]]
* Irregular heartbeats
* symptoms suggestive of [[heart failure]] [[Edema|(edema]], abdominal distension)
===White Blood Cells===
* [[Fever]]
* Frequent infections
* Flu-like illnesses


A low red blood cell count also can cause shortness of breath; dizziness, especially when standing up; headaches; coldness in your hands or feet; pale skin; and chest pain.
===Platelets===
* [[bruise|Bruises]]
* [[Epistaxis]]
* [[Mucosal bleeding]]
* Pinpoint red spots on [[skin]] and in the [[stool]]
* [[Menorrhagia]]


If you don't have enough hemoglobin-carrying red blood cells, your heart has to work harder to move the reduced amount of oxygen in your blood. This can lead to arrhythmias (irregular heartbeats), a heart murmur, an enlarged heart, or even heart failure.
===Other Symptoms===
Aplastic anemia can cause signs and symptoms that aren't directly related to low blood cell counts. Examples include:
* [[Nausea]]
* [[Skin rashes]]


White Blood Cells
===Paroxysmal Nocturnal Hemoglobinuria===
White blood cells help fight infections. Signs and symptoms of a low white blood cell count include fevers, frequent infections that can be severe, and flu-like illnesses that linger.
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]]
Platelets
* [[Swelling]] or pain in the [[abdomen]] or swelling in the legs caused by [[blood clots]]
Platelets stick together to seal small cuts or breaks on blood vessel walls and stop bleeding. People who have low platelet counts tend to bruise and bleed easily, and the bleeding may be hard to stop.
* [[Blood]] in the [[urine]]
 
* [[Headaches]]
Common types of bleeding associated with a low platelet count include nosebleeds, bleeding gums, pinpoint red spots on the skin, and blood in the stool. Women also may have heavy menstrual bleeding.
* [[Jaundice]]
 
Other Signs and Symptoms
Aplastic anemia can cause signs and symptoms that aren't directly related to low blood cell counts. Examples include nausea (feeling sick to your stomach) and skin rashes.
 
Paroxysmal Nocturnal Hemoglobinuria
Some people who have aplastic anemia have a red blood cell disorder called paroxysmal (par-ok-SIZ-mal) nocturnal hemoglobinuria (HE-mo-glo-bi-NOO-re-ah), or PNH. Most people who have PNH don't have any signs or symptoms.
 
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 (a yellowish color of the skin or whites of the eyes)
In people who have aplastic anemia and PNH, either condition can develop first.
 
==Symptoms==
* [[Malaise]], [[fatigue]], and [[pallor]] (Anemia)
* Increased risk of [[hemorrhage]], [[bruising]], and [[menorrhagia]] ([[thrombocytopenia]]).
* Increased risk of [[infection]] ([[leukopenia]])


==Diagnosis and management of aplastic anemia <ref name="pmid19673883">{{cite journal| author=Marsh JC, Ball SE, Cavenagh J, Darbyshire P, Dokal I, Gordon-Smith EC et al.| title=Guidelines for the diagnosis and management of aplastic anaemia. | journal=Br J Haematol | year= 2009 | volume= 147 | issue= 1 | pages= 43-70 | pmid=19673883 | doi=10.1111/j.1365-2141.2009.07842.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19673883  }} </ref> (DONOT EDIT)==
==Diagnosis and management of aplastic anemia <ref name="pmid19673883">{{cite journal| author=Marsh JC, Ball SE, Cavenagh J, Darbyshire P, Dokal I, Gordon-Smith EC et al.| title=Guidelines for the diagnosis and management of aplastic anaemia. | journal=Br J Haematol | year= 2009 | volume= 147 | issue= 1 | pages= 43-70 | pmid=19673883 | doi=10.1111/j.1365-2141.2009.07842.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19673883  }} </ref> (DONOT EDIT)==
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* Patients presenting with [[aplastic anaemia]] should be assessed to:
* Patients presenting with [[aplastic anaemia]] should be assessed to:
** Confirm the diagnosis and exclude other possible causes of [[pancytopenia]] with hypocellular [[bone marrow]]
** 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
** Classify the disease severity using standard [[blood]] and [[bone marrow]] criteria
** Document the presence of associated [[paroxysmal nocturnal haemoglobinuria]] (PNH) and cytogenetic clones
** Document the presence of associated [[paroxysmal nocturnal haemoglobinuria]] (PNH) and cytogenetic clones
** Exclude a possible late onset inherited bone marrow failure disorder
** Exclude a possible late onset inherited bone marrow failure disorder
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{{reflist|2}}
{{reflist|2}}


[[Category:Needs content]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Autoimmune diseases]]
[[Category:Autoimmune diseases]]

Latest revision as of 02:14, 3 December 2018

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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.[1]

Red Blood Cells

White Blood Cells

  • Fever
  • Frequent infections
  • Flu-like illnesses

Platelets

Other Symptoms

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

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:

Diagnosis and management of aplastic anemia [2] (DONOT EDIT)

“

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:
  • Multidisciplinary approach
  • Referral to specialist if necessary
 ”

References

  1. ↑ Shallis RM, Ahmad R, Zeidan AM (July 2018). "Aplastic anemia: etiology, molecular pathogenesis and emerging concepts". Eur. J. Haematol. doi:10.1111/ejh.13153. PMID 30055055.
  2. ↑ Marsh JC, Ball SE, Cavenagh J, Darbyshire P, Dokal I, Gordon-Smith EC; et al. (2009). "Guidelines for the diagnosis and management of aplastic anaemia". Br J Haematol. 147 (1): 43–70. doi:10.1111/j.1365-2141.2009.07842.x. PMID 19673883.
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