Aplastic Anemia

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Aplastic anemia is a serious condition caused by bone marrow failure or toxicity. It is life threatening in serious cases. The bone marrow is replaced by fatty tissue (adipose) and is no longer able to produce blood cells. It commonly affects all three blood cell lines – red blood cells, white blood cells & platelets causing anemia, inability to fight infections & foreign particles, also bleeding problems (hemorrhage). A bone marrow aspiration or biopsy is essential to see which cell lines are being affected & is used to confirm the diagnosis.

CAUSES: Ehrlichiosis, other rickettsial organism infections, parvovirus, estrogen, non-steroidal anti-inflammatory drugs, other drug reactions such as stilboestrol, phenylbutazone, meclofenamic acid, cephalosporins, trimethoprim-sulfamethoxazole, thiacetarsamide, captopril, griseofulvin, quinidine, Sertoli cell tumor, lymphoma, lupus erythematosus, toxins, albendazole (a parasite treatment), some antibiotics, chemotherapy, radiation. Every effort should be made to determine & eliminate the cause. Sometimes, the cause may never be found & would be referred to as Idiopathic Aplastic Anaemia.

SYMPTOMS: Weakness, lethargy, persistent & recurrent infections, fever (possibly with panting), blood in the urine, nosebleeds, pale mucous membranes (e.g. gums), black or darkened stools due to blood in feces (poo), petechial hemorrhage, weight loss & possibly, vomiting.

TREATMENT: Hospitalisation & blood transfusion(s) will be needed in severe cases, together with high dose, long term, broad spectrum antibiotics if there is any underlying infection. Immuno-suppressants (e.g. high-dose Prednisolone, Azathioprine, Cyclosporine etc) & bone marrow stimulating drugs are given. In cases where the marrow is unable to recover, bone marrow transplantation is an option, providing a suitable donor can be found.