APLASTIC ANEMIA

CONTENTS

INTRODUCTION

Figure 1:Bone Marrow

CAUSES

Figure 2:Epstein Barr virus Figure 3: Parovirus

STATISTICS

SYMPTOMS

Figure 4:Red spots Figure 5:Bruise

LAB DIAGNOSIS1. Complete blood count (CBC)

(a) low RBC, WBC, platelets

(b) low Hb and Ht level

2. Reticulocyte count

COMPONENT NORMAL VALUE

MALE FEMALE

RBC 4.7 – 6.1 mil cell/mcL 4.2 – 5.4 mil cell/mcL

Hemoglobin 13.8 – 17.2 gm/dL 12.1 – 15.1 gm/dL

Hematocrit 40.7 – 50.3 36.1 – 44.3

WBC 4500 – 10 000 cell/mcL

Platelet 150 000 - 400 000 /mcL

Reticulocyte 0.5 – 1.5%

3. Bone marrow test (a) BM aspiration (fluid) (b) BM biopsy (tissue)

4. Antibody test

5. Other test a) Vitamin B12 & folate test b) Liver test & viral test c) X-ray, CT scan d) ultrasound imaging test

Figure 6: BM Biopsy

TREATMENT

1. Stem cell transplant

2. Immunosuppressant

3. Blood transfusion

4. Bone marrow stimulant

5. Antibiotics & antiviral

Figure 7:Blood transfusion

PREVENTION

Avoid exposure to:

a) Insecticide

b) Herbicides

c) Organic solvents

d) Toxic chemical

Figure 8: Exposure to herbicides

CONCLUSION

Aplastic anemia - blood disorder that can be inherited or acquired

Serious problem - no enough oxygen supply in body - infection

Treatment - medications, stem cell transplant & blood transfusion

Patients are advised to:

a)Take good rest when neededb)Avoid contact sportsc)Be hygienic

CASE STUDY

1. Patient’s Detail

46 years old male Hepatitis C virus (HCV) infection Combination treatment of PEG-IFN-a 2a (180 μg, weekly) and

ribavirin (1200 mg/day) was commenced for a period of 48 weeks

2. Symptoms

Bleeding tendency Unexplained fatigue of recent onset

3. Physical Examination

Generalized purpura and bruising, pallor of the skin and mucous membranes

The patient’s liver, spleen and lymph nodes- not enlarged

Figure 9: A bone marrow biopsy showing the absence of hematopoietic tissue and its replacement with fat.

4. TREATMENT

Allogeneic bone marrow transplantation after completing two courses of immunosuppressive.

Therapy with antithymocyte globulin and cyclosporin A.

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2013, http://www.bodyandhealth.canada.com Anonymous, (2005), Causes of aplastic anemia, Viewed on 8thth

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Anonymous, (2008), Aplastic anemia, Viewed on 8thth February 2013, http://www.uth.tmc.edu/pathology/medic.html

Anonymous, (2012), Statistics of aplastic anemia, Viewed on 8thth

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http://www.nhlbi.nih.gov/health/health-topics/topics/aplastic/ Anonymous, (2013), bone marrow biopsy, prevention, viewed on 8th

February 2013, http://www.mayoclinic.com/health/medical/IM01819 Anonymous, (2011), CBC, viewed on 8th February 2013,

http://www.aamds.org/about/blood-and-bone-marrow-basics/CBC

Anonymous, (2013), treatment, prevention, viewed on 8th February

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http://www.aamds.org/about/aplastic-anemia

Ioannou, S., Hatzis, G., Vlahadami, I., Voulgarelis, M.(2010),Aplastic anemia associated with interferon alpha 2a in a patient with chronic hepatitis C virus infection: a case report. J Med Case Rep. 4(268)