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Aplastic anemia

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Aplastic anemia is a rare blood disease wherein the bone marrow cannot produce enough new blood cells to replace dying and damaged ones. Blood cells grow old and die over time. Red blood cells usually live for about 120 days, platelets for about 6 days while white blood cells do not last more than 24 hours. One of the main functions of the bone marrow is to continually produce and supply the body with new blood cells in order to address systemic functions like immunity, tissue oxygenation and many others.

APLASTIC ANEMIA DEFINITION

Anemia is described as lack of hemoglobin or red blood cells. Aplastic anemia is described as lack of all blood cells namely red and white blood cells and platelets. The condition may be acquired or hereditary in nature. It is possible for individuals to suddenly have the blood disorder while others may be carrying the trait for several years before manifesting symptoms. The problem can be fatal if not properly attended. Aplastic anemia is more rampant in Asian countries affecting 15 in every 1 million individuals. In the United States, 3 in every 1 million are afflicted.

APLASTIC ANEMIA SIGNS AND SYMPTOMS

Signs and symptoms of aplastic anemia may vary depending on the type of lacking blood cells. These can also range from very mild to extremely severe depending on the remaining number of blood cells available. People should know that immature blood cells do not function normally or cannot function at all so unless normal blood levels are reached, patients will most likely continue to manifest symptoms. Lack of red blood cells or erythrocytes can cause fatigue, body weakness, shortness of breath and skin paleness. Lack of white blood cells or leukocytes can cause fever, infections and other conditions from pathogens due to minimized immune response. Lack of platelets or thrombocytes can cause hematoma, bruising, susceptibility to bleeding and skin petechiae described as red pinpoint spots.

Lack of red blood cells is called anemia, lack of white blood cells is called leukopenia and lack of platelets is called thrombocytopenia. Other characteristics of the blood disease are pale or bluish fingernails due to inadequate tissue perfusion, fast heartbeat, rapid pulse, heart murmurs or arrhythmia, nosebleed or epistaxis, bleeding gums, headache, dizziness, nausea, vomiting, shortness of breath, bloody stool, sinus tenderness, enlarged spleen or liver, oral thrush and slow wound healing with excessive bleeding. Severe symptoms like heavy internal bleeding and heart arrhythmias should be treated immediately or the condition may end fatally.

Aplastic anemia may be classified according to how it developed in the affected individual or according to severity. Depending on the symptoms the condition may be referred to as mild, moderate or severe aplastic anemia. If blood cell levels are just below normal, the condition is considered mild. As numbers continue to drop and reach dangerous levels, doctors will consider the problem as severe requiring immediate medical attention. Damaged or dysfunctional stem cells are usually the main cause since these should mature and become any of the three blood cell types. Autoimmune disorders and trauma can disrupt proper production.
aplastic anemia
Image: Aplastic anemia


Acquired aplastic anemia is defined as obtaining or developing the blood problem during a person’s lifetime while hereditary aplastic anemia is defined as obtaining or developing the blood problem during conception or birth. The more common type would be acquired aplastic anemia which can be treated and last only for a short period of time. The acquired type may stem from exposure to toxic materials and chemicals, chemotherapy drugs, viral infections and radiation. Most cases’ origins remain unknown. The hereditary type is rare and can occur with other underlying conditions like hepatitis and Fanconi anemia.

APLASTIC ANEMIA TREATMENT

Severe cases need to be treated as soon as possible. Mild and moderate cases may develop but in the meantime do not immediately require hospitalization. Blood transfusion is one of the most common treatment approaches in order to provide enough blood cells to patients. This is not a cure but rather an alleviation technique to help improve overall condition and support various processes in the body. Hemapheresis is the term used to provide platelets to patients suffering from bleeding problems. There are 4 different blood types in which the donor and recipient should be matched for carefully.

APLASTIC ANEMIA CAUSES

Immunosuppresant medications may be useful if the condition is caused by an autoimmune disorder wherein the white blood cells and other systemic responses attack the bone marrow. Cyclosporine, corticosteroid and anti-thymocyte globulin drugs like Gengraf, Medrol, Sandimmune and Thymoglobulin are good examples. These act to suppress and control immune cell activity to allow the bone marrow to produce healthy new blood cells. Some drugs can also enhance and stimulate the bone marrow to produce healthy new blood cells such as sagramostim, filgrastim and epoetin alfa. Antibiotics may also be given to help fight off infection due to low white blood cell count.


Bone marrow transplant may also be done which requires a suitable donor. The procedure involves surgically extracting healthy bone marrow from the donor then injecting it intravenously into the patient’s bloodstream. Production of healthy new cells will most likely occur within 3 to 4 weeks. Certain drugs are also provided to the patient to prevent bone marrow rejection. If the problem is caused by drugs, these should be eliminated as soon as possible. Radiation and chemotherapeutic agents should be depleted from the individual’s system to enhance recovery.

APLASTIC ANEMIA PREVENTION

Aplastic anemia can be prevented by being cautious about taking different drugs and medications as well as exposure to toxic substances and radiation. Examples of things to watch out for would be pesticides, pollution, insecticides and the like. Underlying conditions like hepatitis should also be avoided through clean health practices. Some forms of the disorder cannot be prevented but people can help reduce genetic passing of traits through careful family planning. Prognosis of aplastic anemia is usually good especially if detected early. Severe cases are more dangerous wherein majority of those who do not respond well to treatment dies.
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