Aplastic anemia

Background

• absence or decrease number of hematopoietic precursor cells --> pancytopenia (anemia, thrombocytopenia, neutropenia)
• causes
  • drug-induced (chloramphenicol, carbamazepine, valproic acid, phenytoin)
  • viral infection (parvovirus B19, HIV, hepatitis), especially in patients w/ sickle cell disease or immunocompromise
  • autoimmune
  • congenital (Fanconi anemia)

Clinical Features

• anemia
  • weakness, fatigue, dyspnea
• thrombocytopenia
  • mucosal bleeding, petechiae
• neutropenia
  • recurrent infections, fever

Diagnosis

• CBC: pancytopenia
• Reticulocyte count: reduced or absent
• Peripheral smear

Management

• transfuse PRBCs/platelets as needed for severe anemia/thrombocytopenia
• antimicrobials if febrile and neutropenic

See Also

• Aplastic Crisis