B Aplastic Anemia

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    • Aplastic Anemia
      • syndrome of chronic primary hematopoietic failure and attendant pancytopenia (anemia, neutropenia, and thrombocytopenia).
      • Persistent marrow aplasia occur most commonly viral hepatitis of the non-A, non-B, non-C, non-G type (MCQ)
      • Fanconi anemia
        • autosomal recessive disorder  (MCQ)
        • caused by defects in a multiprotein complex that is required for DNA repair  (MCQ)
        • Marrow hypofunction
        • accompanied by multiple congenital anomalies
          • hypoplasia of the kidney and spleen
          • Bone anomalies, which most commonly involve the thumbs or radii. (MCQ)
      • Inherited defects in telomerase are found in 5% to 10% of adult-onset aplastic anemia  (MCQ)
      • about 65% of cases fall into this idiopathic category. (MCQ)
      • Antithymocyte globulin and cyclosporine are used in treatment
      • they suppress or kill autoreactive T-cell clones. (MCQ)
      • Morphology
        • markedly hypocellular bone marrow is largely devoid of hematopoietic cells;
        • often only fat cells, fibrous stroma, and scattered lymphocytes and plasma cells remain. (MCQ)
        • Marrow aspirates often yield little material (a “dry tap”);
        • aplasia is best appreciated in marrow biopsies
        • If the anemia necessitates multiple transfusions, systemic hemosiderosis can appear.
        • Splenomegaly is characteristically absent (MCQ)
          • if  splenomegaly is present, the diagnosis of aplastic anemia should be seriously questioned.
        • The red cells are usually slightly macrocytic and normochromic.
        • Reticulocytopenia is the rule. (MCQ)
      • The diagnosis rests on examination of a bone marrow biopsy.
      • other causes of pancytopenia (MCQ)
        • “aleukemic” leukemia
        • myelodysplastic syndromes
      • In aplastic anemia, the marrow is hypocellular (and usually markedly so), myeloid neoplasms are associated with hypercellular marrows filled with neoplastic progenitors. (MCQ)
      • Bone marrow transplantation  is treatment of choice in those with a suitable
    • Pure Red Cell Aplasia
      • a primary marrow disorder
      • only erythroid progenitors are suppressed
      • may occur in association with
        • thymoma  (MCQ)
        • large granular lymphocytic leukemia
        • drug exposures
        • autoimmune disorders,
        • parvovirus infection  (MCQ)
    • Myelophthisic anemia
      • a form of marrow failure
      • caused by space-occupying lesions replace normal marrow elements
      • Causes
        • commonest cause is metastatic cancer (MCQ)
          • most often carcinomas arising in the breast, lung, and prostate. (MCQ)
        • any infiltrative process (e.g., granulomatous disease) involving the marrow can produce identical findings.
      • Leukoerythroblastosis is seen  (MCQ)
        • abnormal release of nucleated erythroid precursors and immature granulocytic forms (leukoerythroblastosis) into peripheral smears
      • teardrop-shaped red cells is seen (MCQ)
        • which are believed to be deformed during their tortuous escape from the fibrotic marrow.
      • Major Causes of Aplastic Anemia
        • ACQUIRED
          • Idiopathic
            • Acquired stem cell defects
            • Immune mediated
          • Chemical Agents
            • Dose related
              • Alkylating agents (MCQ)
              • Antimetabolites
              • Benzene
              • Chloramphenicol (MCQ)
              • Inorganic arsenicals
            • Idiosyncratic
              • Chloramphenicol (MCQ)
              • Phenylbutazone
              • Organic arsenicals
              • Methylphenylethylhydantoin
              • Carbamazapine (MCQ)
              • Penicillamine
              • Gold salts
          • Physical Agents
            • Whole-body irradiation
          • Viral Infections
            • Hepatitis (unknown virus)
            • Cytomegalovirus infections
            • Epstein-Barr virus infections
            • Herpes zoster (Varicella zoster)
        • INHERITED
          • Fanconi anemia (MCQ)
          • Telomerase defects

    Anemia Aplasica
    Johns Hopkins Medicine: Aplastic Anemia
    Aplastic Anemia
    Version II of the original AA awareness video.
    Aplastic Anemia Cause, Symptoms and Treatments
    Video on what Aplastic Anemis is and what some of its causes and treatments are. Oh, also some lists of Aplastic Anemia symptoms.
    Aplastic Anemia & Chronic Kidney Disease Related Anemia
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