Acquired Aplastic Anemia

G7: Barrios, David, Esmile

 Patient Results Reference Ranges
WBC Ct 2.9 x 109 / L 4.4 - 11.3 x 109 / L
RBC Ct 3.1 x 1012 / L 4.5 - 5.1 x 1012 / L
Plt Ct 14,000 / uL 150,000 - 400,000 / uL
Hgb 11 g / dL 12 - 16 g / dL
Hct 29% 36 - 45 %
MCV 92 fL 80 - 96 fL
MCHC 28% 33 - 36%
ARC 11,600 / uL 25,000 - 75,000 / uL
ANC 390 1,800 - 7,800
Serum Iron 200 ug / dL 60 - 150 ug / dL
% Transferrin 65 20 - 55
 Patient Results Reference Ranges
WBC Ct D 2.9 x 109 / L 4.4 - 11.3 x 109 / L
RBC Ct D 3.1 x 1012 / L 4.5 - 5.1 x 1012 / L
Plt Ct D 14,000 / uL 150,000 - 400,000 / uL
Hgb D 11 g / dL 12 - 16 g / dL
Hct D 29% 36 - 45 %
Slight macrocytosis in PBS
MCHC D 28% 33 - 36%
ARC D 11,600 / uL 25,000 - 75,000 / uL
ANC D 390 1,800 - 7,800
Serum Iron I 200 ug / dL 60 - 150 ug / dL
% Transferrin I 65 20 - 55
What is the most probable disease? Explain why.
Aplastic Anemia

● Pancytopenia
-Granulocyte count less than 1,500 x 109 / L
-Platelet count less than 50, 000 / uL
-Hemoglobin less than 10 g / dL
What is the most probable disease? Explain why.
Aplastic Anemia

● Repeated / Single exposure to drugs such as:

-antimicrobials -analgesics
-anticonvulsants -antihistaminics

● -increased serum iron -reticulocytopenia

-neutropenia -
thrombocytopenia
What is the most probable disease? Explain why.
Aplastic Anemia

● Viral infections:
-Hepatitis B -Hepatitis C -
Cytomegalovirus
-Measles -Epstein-Barr virus
What is the most probable disease? Explain why.
Aplastic Anemia

● Blood Picture:
-Normochromic, normocytic RBCs

Varying degrees of:

-anisocytosis, poikilocytosis or macrocytosis
What additional tests?
● Bone Marrow Aspiration / Biopsy

● Serological tests for other viral entities

What might be the cause?
Viral infection (Epstein-Barr virus) with drug
(anticonvulsant) intake.
Prognosis for such disease?
● Depends on severity of marrow damage
● Modern Treatment => 60% survival rate

-myelodysplastic syndrome
-paroxysmal nocturnal hemoglobinuria
-acute leukemia
-solid tumors
Pathophysiology
● Direct damage
-Altered Proliferation / Differentiation of Stem Cells

● Immune-mediated destruction
Clinical Signs and Symptoms
Depends on Degree of Deficiency:
-Bleeding (Thrombocytopenia)
-Infection (Neutropenia)
-Typical Signs and Symptoms of Anemia

**Splenomegaly and Lymphadenopathy are ABSENT

Treatment
● Supportive Care:

-Immunosuppressive Therapy
-Hematopoietic Cell Transplantation
References:
Turgeon, M. (2012). Clinical Hematology Theory and
Procedures. 5th Ed.

McPherson, R. Pincus, M. (2015). Henry’s Clinical Diagnosis

and Management by Laboratory Methods. 22nd Ed.

https://emedicine.medscape.com/article/198759-overview