Aplastic Anaemia

Question 1

Define Aplastic Anaemia

Answer 1

Pancytopenia with hypocellular marrow and NO abnormal cells

At least 2 of the following peripheral cytopenias must be present:
Haemoglobin <100 g/L (<10 g/dL)
Platelets <50 × 10⁹/L
Absolute neutrophil count <1.5 × 10⁹/L

Question 2

Aetiology of aplastic anaemia

Answer 2

Idiopathic: autoimmune destruction or suppression of stem cells
Drug exposure e.g. chloramphenicol, NSAIDs
Viral infection - Parvovirus B19, post-hepatitis
Pregnancy
Radiation
Chemicals e.g. benzene
Inherited: Fanconi’s anaemia, Dyskeratosis congenita

Question 3

Symptoms of Aplastic anaemia

Answer 3

Anaemia: Lethargy, SOB
Thrombocytopenia: Bruising, petechiae, bleeding gums, epistaxis
Leukopenia: Recurrent infections

Question 4

Signs of Aplastic anaemia on examination

Answer 4

Pallor
Petechiae and bruising

NO hepatomegaly, splenomegaly or lymphadenopathy

Question 5

Investigations for Aplastic anaemia

Answer 5

FBC: Normochromic anaemia | Leucopenia | thrombocytopenia | reduced reticulocytes

Blood film: NO abnormal cells (exclude leukaemia)

Bone marrow trephine biopsy: Hypocellular marrow with decrease in all elements
Marrow space composed of fat cells and marrow stroma (exclude lymphoma, leukaemia, malignancy, myeloma, myelofribrosis)