Aplastic Anemia

Aplastic Anemia

Aplastic anemia is a condition when the bone marrow is unable to produce enough new blood cells. This disease causes the number of one or all types of red blood cells to decrease.

Aplastic anemia can affect anyone, but it's more common in people in their early 20s and the elderly. Early symptoms of aplastic anemia are easy fatigue, pale skin, shortness of breath, and dizziness. Sufferers of this condition are also susceptible to infection due to a lack of leukocytes or white blood cells ( leukopenia ).

Causes of Aplastic Anemia

Aplastic anemia occurs when stem cells in the bone marrow are damaged. This stem cell damage causes blood cell production to slow down or even decrease. As a result, the number of red blood cells (erythrocytes), white blood cells (leukocytes), and platelets (platelets) decreases.

Some conditions or diseases that can cause aplastic anemia are:

  • Autoimmune
    diseases Autoimmune diseases occur when the body's immune system attacks healthy cells, including stem cells in the bone marrow. If not treated immediately, the risk of developing aplastic anemia will increase.
  • Genetic disorders
    A person can get aplastic anemia if they have a family history of a similar disease. In addition, a genetic disorder called Fanconi anemia can also cause this disease.
  • Viral infections Viral
    infections that attack the bone marrow can also cause aplastic anemia. Several types of viruses that are often associated with aplastic anemia are Hepatitis , Epstein-Barr , Cytomegalovirus , Parvovirus B19 ( human parvovirus ), and human immunodeficiency virus ( HIV ).
  • Radiotherapy and chemotherapy
    Radiotherapy and chemotherapy are types of therapy to treat cancer. This method carries the risk of side effects, including damaging stem cells in the bone marrow and increasing the risk of aplastic anemia.
  • Use of certain drugs Certain
    drugs, such as the antibiotic chloramphenicol and drugs used to treat rheumatoid arthritis , can damage the bone marrow and increase the risk of developing aplastic anemia.
  • Exposure to chemicals
    Continuous exposure to chemicals, such as pesticides , insecticides, and benzene, can also cause aplastic anemia.
  • Pregnancy
    Pregnancy sometimes makes a pregnant woman's immune system attack and damage the bone marrow.

In addition to the conditions described, aplastic anemia can be caused by unknown factors. This condition is often called idiopathic aplastic anemia.

Symptoms of Aplastic Anemia

Each type of blood cell has a different function. Leukocytes play a role in the body's immunity, while platelets play an important role in the blood clotting process. Meanwhile, erythrocytes contain hemoglobin, which plays a role in the distribution of oxygen and nutrients throughout the body.

Symptoms of aplastic anemia can vary, depending on the function of the blood cells that are affected. However, common symptoms are:

  • Easily tired and weak
  • Hard to breathe
  • pale skin
  • Dizzy
  • Headache
  • Fever
  • The skin bruises or bleeds easily
  • Recurrent infections that take a long time to heal
  • Nosebleed

When to see a doctor

Immediately consult a doctor if you experience the above symptoms. You are also advised to seek medical help immediately if you experience bleeding that is difficult to stop or an infection that is recurrent and difficult to heal.

Diagnosis of aplastic anemia

To diagnose aplastic anemia, the doctor will conduct a question and answer regarding the complaints experienced, the patient's and family's medical history, as well as the drugs that are being consumed, then proceed with a physical examination.

After that, to confirm the diagnosis, the doctor will carry out supporting examinations in the form of:

  • Blood
    tests Blood tests are done to look at the levels of red cells, white blood cells, platelets, and hemoglobin. Patients are suspected of having aplastic anemia if the number of one or all of the cells is below normal limits.
  • Bone marrow
    biopsy Examination of bone marrow biopsy is done by taking a sample of bone marrow to be examined under a microscope. This examination is also carried out to rule out other possible causes.

Treatment of Aplastic Anemia

Treatment of aplastic anemia depends on the condition and severity of the patient. The following are types of treatment for aplastic anemia:

1. Antibiotics and antivirals

Patients with aplastic anemia are prone to infection. Therefore, antibiotics or antivirals will be given by the doctor to treat the infection.

2. Blood transfusion

If the level and number of blood cells is reduced drastically, blood transfusions can be given to relieve symptoms and meet the needs of blood cells.

3. Immunosuppressants

Administering immunosuppressant drugs is done to suppress the activity of the immune system that damages the bone marrow. Immunosuppressants will be given to sufferers of aplastic anemia due to autoimmune diseases. Some types of drugs used are ciclosporin or corticosteroids .

4. Stem cell transplant

A stem cell transplant or bone marrow transplant is performed to replace damaged cells with healthy cells. This method is usually performed on patients under 40 years of age and get a suitable donor, such as a sibling.

This method can also be done in patients whose symptoms do not improve after using immunosuppressants. However, this procedure also carries risks if the patient's body rejects the donor's stem cells.

5. Bone marrow stimulant

Administration of drugs, such as filgrastim , pegfilgrastim, and epoetin alfa , can be done to stimulate the bone marrow to produce new blood cells. This method is often combined with the administration of immunosuppressants.

Complications of Aplastic Anemia

If not treated, aplastic anemia can cause complications in the form of:

  • Severe infection
  • Bleeding
  • Iron buildup in the body ( hemochromatosis )
  • Myelodysplastic syndrome
  • Blood cancer ( leukaemia )
  • Lymph node cancer ( lymphoma )

Prevention of Aplastic Anemia

There is no way to prevent aplastic anemia. However, to reduce the risk of developing aplastic anemia, you should avoid exposure to chemicals, such as pesticides, insecticides, organic solvents and paint removers.

If you suffer from aplastic anemia, there are several ways you can do to prevent this condition from getting worse or causing complications, namely:

  • Get regular treatment and control at the doctor
  • Wash your hands frequently , especially after using the toilet or doing outdoor activities
  • Avoid sports that involve physical contact, to prevent bleeding
  • Adequate rest time after activities and sleep at night
  • Complete immunization , especially in children, by consulting a doctor first
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