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(A-Z listing includes diseases, conditions, tests and procedures)

Aplastic Anemia

What is aplastic anemia?

Aplastic anemia occurs when your bone marrow doesn’t make enough red and white blood cells, and platelets. A reduced number of red blood cells causes hemoglobin to drop.

Hemoglobin is the part of blood that carries oxygen through the body. A reduced number of white blood cells makes you more prone to infection. And, a reduced number of platelets makes the blood too thin so that it does not clot the way it should.

Aplastic Anemia

Aplastic anemia occurs when your bone marrow doesn’t make enough red and white blood cells, and platelets. The body's immune system is confused and begin to attack these critical performing cells.

What causes aplastic anemia?

Aplastic anemia has multiple causes. Sometimes it occurs for no known reason. Other causes are related to a previous illness or disorder. Acquired causes may include:

  • History of specific infectious diseases, such as hepatitis, Epstein-Barr virus (EBV), cytomegalovirus (CMV), parvovirus B19, or HIV

  • History of taking certain medications, such as antibiotics and anticonvulsants

  • Exposure to certain toxins, such as heavy metals

  • Exposure to radiation

  • History of an autoimmune disease, such as lupus

  • Inherited condition

Who is at risk for aplastic anemia?

Although aplastic anemia can occur at any age, it is more common among teens, young adults, and the elderly. Your risk for this condition increases if you are exposed to toxins, take certain medications, or have diseases such as hepatitis or HIV.

What are the symptoms of aplastic anemia?

The following are the most common symptoms of aplastic anemia. However, each person may experience symptoms differently. Symptoms may include:

  • Headache

  • Dizziness

  • Nausea

  • Shortness of breath

  • Bruising

  • Lack of energy or tiring easily (fatigue)

  • Abnormal paleness or lack of color of the skin

  • Blood in stool

  • Nosebleeds

  • Bleeding gums

  • Fevers

  • Sinus tenderness

  • Enlarged liver or spleen

  • Oral thrush (white patches on a red, moist, swollen surface, occurring anywhere in the mouth)

The symptoms of aplastic anemia may look like other blood disorders or medical problems. Always consult your health care provider for a diagnosis.

How is aplastic anemia diagnosed?

In addition to a complete medical history and physical exam, diagnostic tests for aplastic anemia may include:

  • Blood tests. These may include blood chemistries, evaluation of liver and kidney functions, and genetic studies.

  • Bone marrow aspiration and/or biopsy. A procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.

How is aplastic anemia treated?

Specific treatment for aplastic anemia will be determined by your health care provider based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Aplastic anemia is a serious illness, and treatment usually depends on the underlying cause. For certain causes, recovery can be expected after treatment; however, relapses can occur. To treat the low blood counts, initially treatment is usually supportive and may include:

  • Blood transfusion (both red blood cells and platelets)

  • Preventative antibiotic therapy

  • Practice good hygiene, including meticulous hand-washing, to prevent infection

  • Special care to food preparation (such as only eating well-cooked foods)

  • Avoiding construction sites, which may be a source of certain fungi

  • Medications to stimulate the bone marrow to produce cells

  • Treatment to suppress the immune system

  • Hormone therapy

In certain people, bone marrow transplantation may cure aplastic anemia.

Living with aplastic anemia

Managing aplastic anemia includes working closely with your health care provider and following your treatment plan. It is important that you tell your health care provider of any symptoms you are having. You are more susceptible to infections, so stay away from those who are sick, avoid large crowds, wash your hands often, avoid undercooked foods, brush your teeth regularly, and get your annual flu shot. Develop a physical fitness plan with your health care provider.

Key points about aplastic anemia

  • Aplastic anemia occurs when the bone marrow doesn't make enough red and white blood cells, and platelets.

  • Aplastic anemia can cause you to feel tired, increase your risk of infections, and make you bruise or bleed more easily.

  • To treat the low blood counts initial treatment involves relieving symptoms.

  • Treatments may include blood transfusions, antibiotics, medications to stimulate bone marrow production, and other therapies.

  • In some cases, bone marrow transplantation may cure aplastic anemia.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.

  • Bring someone with you to help you ask questions and remember what your provider tells you.

  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.

  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your provider if you have questions.

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