Aplastic anemia laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Patients with aplastic anemia have a hypoplastic bone marrow (<20% cellularity), pancytopenia (transfusion-dependent anemia, thrombocytopenia, and severe neutropenia), a low reticulocyte count, and with normal maturation of all cell lines.
Laboratory Findings
Complete Blood Count
Often, the first test used to diagnose aplastic anemia is a complete blood count (CBC). The CBC measures many parts of your blood.
This test checks your hemoglobin and hematocrit (hee-MAT-oh-crit) levels. Hemoglobin is an iron-rich protein in red blood cells. It carries oxygen to the body. Hematocrit is a measure of how much space red blood cells take up in your blood. A low level of hemoglobin or hematocrit is a sign of anemia.
The normal range of these levels varies in certain racial and ethnic populations. Your doctor can explain your test results to you.
The CBC also checks the number of red blood cells, white blood cells, and platelets in your blood. Abnormal results may be a sign of aplastic anemia, an infection, or another condition.
Finally, the CBC looks at mean corpuscular (kor-PUS-kyu-lar) volume (MCV). MCV is a measure of the average size of your red blood cells. The results may be a clue as to the cause of your anemia.
Reticulocyte Count A reticulocyte (re-TIK-u-lo-site) count measures the number of young red blood cells in your blood. The test shows whether your bone marrow is making red blood cells at the correct rate. People who have aplastic anemia have low reticulocyte levels.
Bone Marrow Tests (Aspiration and biopsy)
- Bone marrow aspiration might be done to find out if and why bone marrow isn't making enough blood cells. For this test, a small amount of bone marrow fluid is aspirated through a needle. The sample is looked at under a microscope to check for faulty cells.
- A bone marrow biopsy might be done at the same time as an aspiration or afterward. For this test, your doctor removes a small amount of bone marrow tissue through a needle. The tissue is checked for the number and types of cells in the bone marrow. In aplastic anemia, the bone marrow has a lower than normal number of all three types of blood cells.
- Bone marrow biopsy (hypoplastic bone marrow (<20% cellularity), and with normal maturation of all cell lines.
- Full blood count (pancytopenia (anemia, thrombocytopenia, and severe neutropenia)
- Peripheral blood smear (normocytic RBC, decreased or absent reticulocytes)
- Renal function
- Electrolytes
- Liver enzymes
- Thyroid function tests
- vitamin B12 and folic acid levels.