Aplastic anaemia Flashcards
1
Q
Define
A
DEFINITION: characterised by diminished haematopoietic precursors in the bone marrow and deficiency of all blood cell elements (pancytopaenia)
2
Q
Causes
A
Idiopathic (> 40%)
- May be due to destruction or suppression of stem cells via autoimmune mechanisms
Acquired
- Drugs (e.g. chloramphenicol, sulphonamides, methotrexate)
- Chemicals (e.g. benzene, DDT)
- Radiation
- Viral infection (e.g. parvovirus B19)
- Paroxysmal nocturnal haemoglobinuria
Inherited
- Fanconi’s anaemia
- Dyskeratosis congenita (a rare, progressive bone marrow failure syndrome)
3
Q
Epidemiology
A
Annual incidence: 2-4/1,000,000
Slightly more common in males
4
Q
Symptoms
A
Can be both slow-onset (months) or rapid-onset (days)
Anaemia Symptoms:
- Tiredness
- Lethargy
- Dyspnoea
Thrombocytopaenia Symptoms:
- Easy bruising
- Bleeding gums
- Epistaxis
Leukopaenia Symptoms:
- Increased frequency and severity of infections
5
Q
Signs
A
Anaemia Signs:
- Pallor
Thrombocytopaenia Signs:
- Petechiae
- Bruises
Leukopaenia Signs:
- Multiple bacterial and fungal infections
- No hepatomegaly, splenomegaly or lymphadenopathy
6
Q
Investigations
A
Bloods
FBC
- Low Hb
- Low platelets
- Low WCC
- Normal MCV
- Low or absent reticulocytes
Blood Film
- Exclude leukaemia (check for abnormal circulating white blood cells)
Bone Marrow Trephine Biopsy
Fanconi’s Anaemia
- Check for presence of increased chromosomal breakage in lymphocytes cultures in the presence of DNA cross-linking agents
