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aplastic anemia
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Anemia of diminished erythropoeisis
Nutritional deficiencies
Anemia due to renal insufficiency
Anemia of chronic disease
Generalized bone-marrow disorders
Aplastic anemia
Primary hematopoeitic neoplasms
Infiltrative disorders due to marrow replacement
Aplastic and Hypoplastic Anemias
What happens when the bone marrow shuts down?
Aplastic anemia
Aplastic anemia is a severe, life threatening syndrome in which production of erythrocytes, WBCs, and platelets has failed.
Aplastic anemia may occur in all age groups and both genders.
The disease is characterized by peripheral pancytopenia,reticulocytopenia and accompanied by a hypocellular bone marrow.
Classification Acquired
Idiopathic
Chemical agents
Idiosyncratic
Physical agents
Viral infections
Miscellaneous
Inherited Fanconis anemia
Telomerase deficiency
Hypocellular bone marrow in aplastic anemia
Clinical manifestations
Fatigue Heart palpitations Pallor Infections Petechiae Mucosal bleeding NO SPLENOMEGALY
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Aplastic anemia
Lab findings
Severe pancytopenia with relative lymphocytosis (lymphocytes live a long time)
Normochromic, normocytic RBCs (may be slightly macrocytic)
Mild to moderate anisocytosis and poikilocytosis
Decreased reticulocyte count
Hypocellular bone marrow with > 70% yellow marrow
Treatment in untreated cases the prognosis is poor
Remove causative agent, if known
Anti-thymocyte globulin
Multiple transfusions
Bone marrow transplant
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Related disorders
Disorders in which there is peripheral pancytopenia, but the bone marrow is normocellular, hypercellular, or infiltrated with abnormal cellular elements
Myelopthesic anemia replacement of bone marrow by fibrotic, granulomatous, or neoplastic cells
Leuco-erythroblastic reaction
Bone-marrow granuloma
Related disorders
Myelodysplastic syndromes are primary, neoplastic stem cell disorders that tend to terminate in acute leukemia. The bone marrow is usually normocellular, or hypercellular with evidence of qualitative abnormalities in one or more cell lines resulting on ineffective erythropoiesis and/or granulopoiesis and/or megakaryopoiesis. The peripheral smear shows dysplastic (abnormality in development) cells including nucleated RBCs, oval macrocytes, pseudo-Pelger-Huet PMNs (hyposegmented neutrophils) with hyperchromatin clumping, hypogranulated neutrophils, and giant bizarre platlets.
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Pure Red Cell Aplasia
Pure red cell aplasia is characterized by a selective decrease in erythroid precursor cells in the bone marrow. WBCs and platelets are unaffected. Acquired
Transitory with viral or bacterial infections
Patients with hemolytic anemias may suddenly halt erythropoiesis
Patients with thymoma T-cell mediated responses against bone marrow erythroblasts or erythropoietin are sometimes produced.
Pure Red Cell Aplasia
Congenital
Diamond-Blackfan syndrome occurs in young children and is progressive. It is probably due to an intrinsic or regulatory defect in the committed erythroid stem cell.
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Other hypoproliferative anemias
Renal disease due to decreased erythropoietin
Endocrine deficiencies
Hepatocellular liver disease
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