What is aplastic anemia?

Aplastic anemia is an autoimmune condition that occurs when your body stops producing enough new blood cells . This condition makes you tired, more prone to infections and uncontrolled bleeding. A rare and serious condition, this type of anemia can develop at any age. It can come on suddenly or come on gradually and get worse over time. It can be mild or severe. Treatment of aplastic anemia may include medications, a blood transfusion, or a stem cell transplant, also known as a bone marrow transplant.

What causes aplastic anemia?

Stem cells in the bone marrow produce blood cells, red blood cells, white blood cells, and platelets. Stem cells are damaged in aplastic anemia. As a result, the bone marrow is either empty (aplastic) or contains too few blood cells (hypoplastic).

The most common cause of this type of anemia is when your immune system attacks the stem cells in your bone marrow. Other factors that can damage the bone marrow and affect blood cell production include:

  • Radiation and chemotherapy treatments: While these cancer-fighting treatments kill cancer cells, they can also damage healthy cells, including stem cells in the bone marrow. Aplastic anemia can be a temporary side effect of these treatments.
  • Exposure to toxic chemicals: Toxic chemicals, some of which are used in pesticides and pesticides, and benzene, a component of gasoline, are closely related to this type of anemia. This type of anemia can improve if you avoid repeated exposure to the chemicals that cause your illness.
  • Use of certain medications: Some medications, such as those used to treat rheumatoid arthritis and some antibiotics, can cause aplastic anemia.
  • Autoimmune disorders: An autoimmune disorder in which your immune system attacks healthy cells, it can also target stem cells in your bone marrow.
  • Viral infection: Viral infections that affect the bone marrow may play a role in the development of this type of anemia. Viruses that have been linked to aplastic anemia include hepatitis, Epstein-Barr, cytomegalovirus, parvovirus B19, and HIV .
  • Pregnancy: Your immune system may attack your bone marrow during pregnancy.
  • Unknown factors: In most cases, doctors cannot determine the cause of aplastic anemia.
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Links to other rare disorders

Some people with aplastic anemia have a rare condition known as paroxysmal nocturnal hemoglobinuria , which causes red blood cells to break down too soon. This may lead to aplastic anemia or the aplastic anemia may evolve into paroxysmal nocturnal hemoglobinuria.

Fanconi anemia is a rare, inherited disease that causes this type of anemia. Children born with this tend to be smaller than average and have birth defects such as undeveloped limbs. The disease is diagnosed with the help of blood tests.

Who is at risk?

Factors that can increase the risk of aplastic anemia include:

  • Treatment with high-dose radiation or chemotherapy for cancer
  • Exposure to toxic chemicals
  • Chloramphenicol, used to treat bacterial infections, and some medications to treat rheumatoid arthritis
  • Certain blood diseases, autoimmune disorders, and serious infections
  • rarely pregnancy

What are the symptoms of aplastic anemia?

Aplastic anemia may sometimes have no symptoms. When symptoms do occur, they usually include:

  • Tiredness
  • Shortness of breath
  • fast or irregular heart rate
  • pale skin
  • Frequent or prolonged infections
  • Unexplained or easy bruising
  • Nosebleeds and bleeding gums
  • Prolonged bleeding from cuts and scratches
  • skin rash
  • dizziness
  • Headache
  • Fire

This type of anemia can be short-lived or become chronic. It can be severe and even fatal.

When should you see a doctor?

If you are experiencing any or more of the above symptoms and there is something else that worries you, you should see a doctor.

How is aplastic anemia diagnosed?

The following tests can help diagnose aplastic anemia:

  • Blood tests: Normally, red blood cell, white blood cell and platelet levels stay within certain ranges. In this type of anemia, all three of these blood cell levels are low.
  • Bone marrow biopsy: A doctor uses a needle to take a small sample of bone marrow from a large bone in your body, such as your hip bone. The sample is examined under a microscope to rule out other blood-related diseases. In aplastic anemia, the bone marrow contains fewer blood cells than normal. A bone marrow biopsy is required to confirm the diagnosis of this type of anemia.
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After you’ve been diagnosed with aplastic anemia, you may need other tests to determine the cause.

How is aplastic anemia treated?

Treatments for aplastic anemia, which will depend on the severity of your condition and your age, may include observation, blood transfusions, medications, or a bone marrow transplant. Severe aplastic anemia, in which your blood cell count is extremely low, is life-threatening and requires immediate hospitalization.

blood transfusions

While there is no cure for this type of anemia, a blood transfusion can control bleeding and relieve symptoms by supplying blood cells that your bone marrow does not produce.

  • Red blood cell transplant: This transplant increases the red blood cell count and helps relieve anemia and fatigue.
  • Platelet transplant: This transplant helps prevent excessive bleeding.

Although there is no limit to the number of blood transfusions in general, complications may occur with more than one transfusion. Transfused red blood cells can sometimes contain enough iron to damage vital organs and this must be treated. Medications can help your body get rid of excess iron.

Over time, your body may develop antibodies against the transplanted blood cells, making them less effective at relieving symptoms. Use of immunosuppressant medication makes this complication less likely.

Remember, your doctor will decide which medicine to take and how.

immunosuppressants

For those who cannot have a bone marrow transplant or whose aplastic anemia is due to an autoimmune disorder, treatment may include drugs that alter or suppress the immune system (immunosuppressants).

Medications such as cyclosporine and anti-thymocyte globulin suppress the activity of immune cells that damage your bone marrow. This helps your bone marrow heal and make new blood cells. Cyclosporine and anti-thymocyte globulin are often used together.

Corticosteroids such as methylprednisolone are often used with these drugs.

Although effective, these drugs further weaken your immune system. It is also possible for the anemia to return after stopping these drugs.

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Remember, your doctor will decide which medicine to take and how.

bone marrow stimulants

Certain medications such as sargramostim, filgrastim, and pegfilgrastim, epoetin alfa, and eltrombopag help stimulate the bone marrow to produce new blood cells. These drugs are often used in conjunction with immunosuppressant drugs.

Remember, your doctor will decide which medicine to take and how.

antibiotics and antivirals

Having this type of anemia weakens your immune system, making you more prone to infections.

If you have aplastic anemia, you should see your doctor at the first sign of infection, such as fever. You don’t want the infection to get worse because it can be life threatening. If you are severely affected by this type of anemia, your doctor may prescribe antibiotics or antiviral medications to help prevent infections.

Remember, your doctor will decide which medicine to take and how.

Other treatments

Aplastic anemia caused by radiation and chemotherapy treatments for cancer usually improve after these treatments are stopped. The same is true for most other drugs that cause this type of anemia.

Pregnant women with this type of anemia are treated with blood transfusions. For many women, pregnancy-related aplastic anemia improves once the pregnancy ends. If this does not happen, treatment is still necessary.

Lifestyle and home remedies

If you have aplastic anemia, you should take care of yourself by:

  • Rest when you need it: Anemia can cause fatigue and shortness of breath, even with light exertion. Take a break and rest when you need it.
  • Avoiding contact sports: Avoid activities that can cause cuts or falls, due to the risk of bleeding associated with a low platelet count.
  • Protecting yourself from germs: Wash your hands often and avoid sick people. If your fever rises or other signs of infection appear, see your doctor for treatment.

Can aplastic anemia be prevented?

So far, no definitive strategy has been found on how to prevent this fateful form of anemia. Avoiding exposure to insecticides, herbicides, organic solvents, paint removers and other toxic chemicals can reduce your risk of disease.

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