Aplastic anemia: what is it, symptoms, photos
Aplastic anemia – a disease of the hemopoietic system that is manifested by depression all her germs. Occurs with a frequency of approximately 2:1000000, equally common among men and women, no preference in race or ethnic group. Affects children and young adults primarily aged 20 to 40 years.
What is it?
The bone marrow of a healthy person represents the place where appear and ripen all blood cells – red cells, white cells and platelets. All these cells are essential for the body.
- Red blood cells carry oxygen and carbon dioxide, in case of their lack in the first place from suffering oxygen starvation to the brain. The lack of red blood cells is called anemia.
- Leukocytes are responsible for fighting viral, bacterial and fungal infections. If they are not enough, a man plagued by constant severe inflammatory disease.
- Platelets are responsible for blood clotting. When their number is below the critical level, appear causeless bleeding and hemorrhage – hemorrhagic syndrome (gemos – blood, «rage» – current).
In aplastic anemia, all of these cells are not enough. Hence the manifestations of the disease, anemia, infectious and hemorrhagic syndromes. A similar pattern is observed in some cancer, for example, in acute leukemia. Therefore, to understand the problem needs an experienced hematologist.
The causes of the disease
It is a severe and life-threatening disease may occur for several reasons:
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- genetic abnormalities (Fanconi anemia and others);
- a viral infection (viral hepatitis, cytomegalovirus, parvovirus, a virus of free wifi-Barr, herpes, HIV);
- unpredictable effects of drugs (found after the chloramphenicol, sulfonamides, chloramphenicol, barbiturates, anti-thyroid, antihistamines, etc.);
- toxic effects (benzene, gold salts and arsenic);
- ionizing radiation.
In most of the cases the cause can not be identified – a condition called «idiopathic aplastic anemia». The mechanism of its occurrence is still unclear – the most likely failure of the immune system when it destroys the cell’s own bone marrow as foreign.
The clinical picture of the disease
All of the many symptoms can be grouped into three syndrome.
To suspect a serious pathology able the doctor of any profile of patient examination. For diagnosis you need the following procedure.
- Common blood test with leukocyte formula (determining the percentage of various cells of the immune system).
- Bone marrow biopsy – with the use of anesthesia is the removal of a small fragment of bone marrow from the iliac crest. The resulting material after special staining examined under a microscope and accurately count all the detected blood cells and their predecessors. Cancer can be eliminated only with the help of this study.
- Ultrasound of abdominal organs: it is particularly important to ascertain the condition of the spleen. It is one of criteria of prognosis of the disease.
Treatment of aplastic anemia
Therapy serves several purposes:
- to compensate for the shortage of red blood cells for this set of patients transfused platelet and Packed red blood cells; so can get rid of anemia and bleeding;
- to resist infections – patients receive a comprehensive antibacterial and antifungal therapy until the level of white blood cells is not sufficient for self-resistance of microorganisms;
- to achieve its own blood cells to stop the attack of immune system on own bone marrow or replace damaged bone marrow with healthy transplant.
In fact, transplantation is the only way to defeat the disease completely. The difficulty lies in the selection of a compatible donor. Possibly looking for him among relatives of the patient. In addition, the earlier the diagnosis and the transplant, the more successful the result, as numerous transfusions of platelets and red blood cells make the immune system produce a lot of antibodies, which increases the likelihood of subsequent transplant rejection.
To deter aggression the immune system is used glucocorticoids, cyclosporine a, cyclophosphamide and antilimfocitarnyi globulin. Treatment is carried out strictly in a hospital in the Department of Hematology under the supervision of red blood cells, platelets, and leukocytes, as well as biochemical analysis of blood, which reflect the condition of the liver and kidneys.
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Removal of the spleen (splenectomy) as sites of production of antibodies has a positive effect after 2 to 5 months in approximately half of patients.
Approximately half of patients can achieve remission. Sometimes the marrow completely restored after treatment. Without treatment, patients die within a few months of hard current infections or hemorrhage.