{"id":2268,"date":"2010-01-14T20:17:04","date_gmt":"2010-01-15T01:17:04","guid":{"rendered":"http:\/\/insidesurgery.com\/?p=2268"},"modified":"2014-06-30T21:11:51","modified_gmt":"2014-07-01T01:11:51","slug":"aplastic-anemia","status":"publish","type":"post","link":"https:\/\/insidesurgery.com\/2010\/01\/aplastic-anemia\/","title":{"rendered":"Aplastic Anemia"},"content":{"rendered":"

Pathophysiology<\/strong><\/p>\n

1)<\/strong> pancytopenia in conjunctiojn with bone marrow hypocellularity 2)<\/strong> biphasic age at presentation – as young adult and in elderly<\/p>\n

Signs and Symptoms<\/strong><\/p>\n

1)<\/strong> abrupt or insidious onset 2)<\/strong> bleeding, easy bruising, retinal hemorrhage 3)<\/strong> malaise\/weakness 4)<\/strong> orthopnea 5)<\/strong> pounding in ears<\/p>\n

Characteristic Test Findings<\/strong><\/p>\n

Laboratory<\/em> – 1)<\/strong> anemia 2)<\/strong> low platelet count 3)<\/strong> neutropenia 4)<\/strong> increased MCV
\n
\nHistology\/Gross Pathology<\/strong><\/p>\n

1)<\/strong> bone marrow replaced by fat and fibrosis with < 1% stem cells present 2)<\/strong> large, scant RBCs 3)<\/strong> few reticulocytes<\/p>\n

Associated Conditions<\/strong><\/p>\n

1)<\/strong> Fanconi’s anemia 2)<\/strong> paroxysmal nocturnal hemoglobinuria 3)<\/strong> myelodysplastic syndromes 4)<\/strong> thymoma 5)<\/strong> eosinophilic faciitis 6)<\/strong> graft versus host disease 7)<\/strong> infections – seronegative hepatitis, EBV, parvovirus-B19, HIV\/AIDS 8)<\/strong> drugs – chloramphenical, cimetidine, quinacrine, phenylbutazone, hydantoins, gold<\/p>\n

Treatment<\/strong><\/p>\n

1)<\/strong> broad-spectrum antibiotics and blood products to temporize 2)<\/strong> bone marrow transplantation if HLA-identical donor available 3)<\/strong> immunosuppression with anti-lymphocyte globulin and\/or antithymocyte globulin and\/or cyclosporine 4)<\/strong> androgen therapy has been tried with mixed success<\/p>\n

Tips for USMLE<\/strong><\/p>\n

if a 21 year-old woman notices easy bruising and extremely heavy menstrual flow, has low platelets, RBC count, and WBC count, and a bone marrow with almost complete replacement of fat cells, think aplastic anemia
\n
\n<\/p>\n","protected":false},"excerpt":{"rendered":"

Pathophysiology 1) pancytopenia in conjunctiojn with bone marrow hypocellularity 2) biphasic age at presentation – as young adult and in elderly Signs and Symptoms 1) abrupt or insidious onset 2) bleeding, easy bruising, retinal hemorrhage 3) malaise\/weakness 4) orthopnea 5) pounding in ears Characteristic Test Findings Laboratory – 1) anemia 2) low platelet count 3) […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[63],"tags":[953,955,956,948,950,939,954,949],"yoast_head":"\nAplastic Anemia - 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