Aplastic anaemia (bone marrow failure)
Introduction
Aplastic anaemia is defined as pancytopenia resulting from aplasia of the bone marrow Pancytopenia – a reduction in the blood count of all the major cell lines
Causes of aplastic anaemia
Primary
• Congenital (Fanconi and non-fanconi
• Idiopathic acquired
Secondary
• Ionozing radiation: Accidental exposure (radiotherapy, radioactive isotopes, nuclear power stations
• Chemicals: Benzene, DDT, insecticides T lymphocyte mediated autoimmune suppression of haemopoietic stem cell
• Drugs esp: chloramphenical Infections esp viral hepatitis (A or non-A Connective tissue diseases, pregnancy
Risk Factors
Signs and symptoms
Vary with severity but include;
• Anaemia
• Easy bruising/bleeding
• Recurrent infection
• Splenomegaly is not a feature.
Diagnostic criteria
• Pancytopenia
• Bone marrow hypocellularity of < 30% hematopoietic cells for children and young adults
• Confirmed by trephine biopsy.
Classification by severity of Aplastic Anaemia (AA)
Severe AA (SAA)
For SAA at least two of the following three criteria have to be fulfilled:
• Reticulocytes <60x109/L (using an automated analyzer) or < 20 x 109/l (manual count) Platelets < 20x109/L Absolute neutrophils <0.5 x109/L
Very severe AA (vSAA)
• For vSAA, the same criteria of SAA have to be fulfilled; however the absolute neutrophil count has to be < 0.2 x109/l
Moderate Aplastic Anaemia (AA)
• Moderate AA is considered when the severity criteria of SAA are not fulfilled
Investigations
Treatment
-
Non-pharmacological
-
-
Pharmacological
-
Prevention
Updated on,
14 Novemba 2020 11:47:51
References
- 1. STG