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Aplastic anemia
From WikEM
Contents
Background
- Absence or decreased 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 with sickle cell disease or immunocompromise
- Autoimmune
- Congenital (Fanconi anemia)
Clinical Features
- Anemia
- Weakness, fatigue, dyspnea
- Thrombocytopenia
- Mucosal bleeding, petechiae
- Neutropenia
- Recurrent infections, fever
Differential Diagnosis
Evaluation
- CBC: pancytopenia
- Reticulocyte count: reduced or absent
- Peripheral smear
Management
- Transfuse PRBCs/platelets as needed for severe anemia/thrombocytopenia
- Antimicrobials if febrile and neutropenic
