Aplastic Anemia: Symptoms, Causes, and Treatment

 severe aplastic anemia

Aplastic anemia is a disease whose main feature is damage to the system responsible for the formation of the three blood compounds from which red blood cells containing hemoglobin develop 

which form white blood cells, and which are platelets responsible for blood clotting, and as a result of this imbalance, there is a significant decrease in the number of the three cells In the bone marrow and in the peripheral blood.

Aplastic Anemia: Symptoms, Causes, and Treatment

The healthy environment in which the compounds of the blood system develop is called a microenvironment, where there are interrelationships between stem cells, which are the source of the development of the compounds of the blood system, and their natural environment.

The disease appears due to acquired or congenital factors.

Types of neonatal aplastic anemia syndrome

Include the following:

Fanconi syndrome: It is a genetic defect that appears as a birth defect in the skeleton, which causes a greater likelihood of developing cancer.

Schwachman-diamond syndrome: accompanied by pancreatic failure and food malabsorption syndrome.

Dyskeratosis congenital: Except for some rare cases, the disease appears only in males and is accompanied by skin problems.

Symptoms of aplastic anemia

Symptoms include:

  • fatigue.
  • Shortness of breath.
  • Fast or irregular heartbeat.
  • pale skin;
  • Recurrent or long-term infection.
  • Unexplained or easy bruising.
  • Nosebleeds and bleeding gums.
  • Prolonged bleeding from wounds.
  • Skin rash.
  • Dizziness.
  • a headache.
  • Fever.

Causes and risk factors for aplastic anemia

The mechanism that leads to aplastic anemia includes an internal defect in stem cells that leads to their failure to develop 

or due to factors in the microenvironment such as an attack by the immune system, or a deficiency of growth factors that stimulate the development of cells in the blood system.

The main reasons include the following:

Chemotherapy: These drugs can cause aplastic anemia in a dose-dependent manner.

Hypersensitivity to certain medicines: such as some types of antibiotics, anti-inflammatory medicines, and blood-thinning medicines.

Radiation therapy: especially when radiotherapy in highly concentrated doses or when continuous exposure to this type of treatment.

Chemicals: Exposure to certain chemicals such as benzene stimulates the disease.

Infection from certain viruses: especially when exposed to a provirus or the AIDS virus.

Pregnancy: In rare cases, pregnancy can lead to aplastic anemia.

Autoimmune diseases such as lupus may sometimes contribute to the development of aplastic anemia.

Complications of aplastic anemia

  1. Complications include the following:
  2. Severe infections or bleeding.
  3. Complications of a bone marrow transplant.
  4. reactions to medications;
  5. Hemochromatosis is a buildup of too much iron in body tissues due to too many red cell transfusions.

Diagnosis of aplastic anemia

Diagnosis includes the following:

1. Blood tests

Normally, red blood cells, white blood cells, and platelet levels remain within certain ranges, but in aplastic anemia all three blood cell levels are low.

2. Bone marrow biopsy

The doctor uses a needle to remove a small sample of bone marrow from a large bone in your body such as the thigh 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, but confirmation of a diagnosis of aplastic anemia requires a bone marrow biopsy.

Aplastic anemia treatment

Treatment for aplastic anemia includes supportive and disease-directed therapy, in which the majority of people who receive supportive treatment die without treatment for the disease itself within a year or two.

Supportive treatment includes the administration of blood compounds and long-term treatment with antibiotics. 

Targeted treatment of the disease includes bone marrow transplantation from a donor, preferably a brother or sister and possibly also from a foreigner, or immunosuppressive therapy and growth factors. The details are as follows:

1. Bone marrow transplant

Bone marrow transplantation is effective in 60% - 90% of patients. The success of treatment depends on the age of the patient, the availability of the donor, and the suitability of the recipient.

The main complications that can result from this treatment are transplant failure and graft versus host disease, a serious disease caused by the graft attacking the recipient patient's organs.

2. Immunosuppressive drugs

If the possibility of transplantation from a donor is not available, the treatment is by immunosuppressive drugs, as the drugs used to suppress the immune system are: Anti-thymocyte globulin (ATG), cyclosporine, and corticosteroids.

The rate of response, whether partial or complete, to these drugs, is 70% - 80%, but only between a quarter to a third of patients fully respond to treatment.

Prevention of aplastic anemia

Aplastic anemia cannot be prevented.

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