Aplastic anemia is a rare disease. About 3 out of every 1 million people in the United States get aplastic anemia each year. The disease appears more often in eastern Asian countries, where it affects about 15 out of every 1 million people. It can affect people of any age.
The bone marrow produces all of the blood cells for the body:
· Red blood cells carry oxygen to all parts of your body.
· White blood cells help the body fight infection.
· Platelets help control bleeding.
Each blood cell lives only a certain number of days, so the body needs a steady supply. Healthy bone marrow is always making new blood cells. However, in aplastic anemia, the marrow makes a much smaller number than normal of all three types of blood cells. In very severe cases, the marrow can stop making any blood cells at all.
In most cases, doctors do not know the cause of aplastic anemia. In about 20% of patients, the disease develops from an inherited disorder, such as Fanconi anemia. Aplastic anemia may also be caused by high doses of radiation or certain chemicals or viruses. There is evidence that in many people aplastic anemia is an autoimmune disease. This means that the body's immune system is reacting against itself. The immune system attacks the bone marrow and stops it from making enough blood cells.
Symptoms
Symptoms of aplastic anemia are caused by low numbers of blood cells. The severity of a person's symptoms depends on the number of blood cells he or she has.
· Low numbers of red blood cells can cause a person to feel tired or weak, be short of breath and look pale.
· Low numbers of white blood cells can lead to frequent or severe infections.
· Low numbers of platelets can lead to easy bleeding or bruising and tiny red spots under the skin (petechiae), or bleeding that is hard to stop.
For a person with moderate aplastic anemia, these symptoms may be mild or moderate. For a person with severe or very severe aplastic anemia, infections or bleeding can be life-threatening.
Diagnosis
To diagnose aplastic anemia, doctors look at samples of blood and bone marrow. In aplastic anemia, the numbers of red blood cells, white blood cells and platelets in the blood are all low. There are two types of samples that can be collected from the bone marrow. A bone marrow aspiration uses a needle to extract a small amount of liquid marrow. A bone marrow biopsy uses a special needle to remove an intact core of marrow. Aspirations and biopsies are both usually taken from the back of the hip bone.
In aplastic anemia, the marrow samples show low numbers of cells. The few cells that do appear are normal (not cancer cells). Based on the number of cells that appear, doctors diagnose the disease as moderate, severe or very severe aplastic anemia. Moderate aplastic anemia sometimes becomes severe over time, so doctors will watch for signs the disease is changing.
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