Skip to main content

Aplastic Anaemia

1. Primary idiopathic acquired aplastic anaemia 
2. Secondary aplastic anaemia

Primary idiopathoc acquired aplastic anaemia

The basic problem is failure of pluripotent stem cells, producing hypoplasia of the bone marrow with a pancytopenia in the blood.

Clinical features and investigations

• Patients present with symptoms of bone marrow failure, usually anaemia or bleeding and less commonly infections.
• FBC shows pancytopenia, low reticulocytes and often macrocytosis.
•Bone marrow aspiration and trephine reveal hypocellularity.

Management

All patients will require blood product support and aggressive management of infection.
The curative treatment is allogeneic HSCT if there is available donor.
In older patients, immunosuppressive therapy with CICLOSPORIN and ANTITHYMOCYTE GLOBULIN gives 5-year survival rates of 75%.

Secondary aplastic anaemia

Clinical features and methods of diagnosis are same as for primary idiopathic aplastic anaemia.

Causes

• Drugs

Cytotoxic drugs
Antibiotics - chloramphenicol, sulphonamides
Antirheumatic agents - penacillamine, gold, phenylbutazone, indometacin
Antithyroid drugs
Anticonvulsants
Immunosuppressants - azathioprine

•Chemicals

Benzene toluene solvent misuse 
Insecticides - DDT
Organophosphates and carbamates

• Radiation
• Viral hepatitis 
• Pregnancy
• paroxysmal nocturnal haemaglobinuria



Labels

Labels:

Comments

Post a Comment

Please do not enter any spam link in the comment box.

Popular posts from this blog

INFECTIVE ENDOCARDITIS (IE)

INFECTIVE ENDOCARDITIS (IE) It is the colonisation of the heart valves with microbiological organisms, leading to the formation of friable, infected vegetations and frequently valve injury. Types ACUTE INFECTIVE ENDOCARDITIS : caused by highly virulent organisms mainly Staphylococcus Aureus (20-30%), seeding a previously normal valve. SUBACUTE INFECTIVE ENDOCARDITIS : caused by organisms of moderate or low virulence mainly STREPTOCOCCI (60-70%), seeding an abnormal or previously injured valve. ENDOCARDITIS OCCURING IN I/V DRUG ABUSERS : caused predominantly by organisms found on the skin (S. aureus, Candida) and affecting the valves on the right side of the heart. PROSTHETIC VALVE ENDOCARDITIS : This may be early ( symptoms appearing within 60 days of valve insertion ), due to intraoperative infection of the valve or insertion of an infected valve or late ( after 60 days of valve insertion), due to late bacteremia. Predisposing factors to developement of IE Congenital cardiac anoma...
Post a Comment
Read more

HYPERTENSION (High Blood Pressure)

HYPERTENSION (High Blood Pressure) The British Hypertension Society classification, defines mild hypertension as existing when the BP is above 140/90 mmHg.  The Cardiovascular risks associated with high BP depend on the combination of risk factors in an individual, such as age, gender, weight, physical activity, smoking, family history, serum cholesterol, diabetes mellitus and pre-existing vascular disease. Classification of Hypertension Causes of Hypertension Alcohol  Obesity  Pregnancy RENAL DISEASE Glomerulonephritis Renal vascular disease Polycystic kidney disease ENDOCRINE DISEASE Pheochromocytoma Cushing's syndrome Primary hyperaldosteronism (Conn's syndrome) Thyrotoxicosis Acromegaly  Primary hypothyroidism Liddle's syndrome Congenital adrenal hyperplasia COARCTATION OF THE AORTA DRUGS Steroids : Anabolic steroids, corticosteroid, oral contraceptive pills. Cyclosporine Beta receptor agonists Sympathomimetics (Cold remedies/ Nasal drops) NSAIDs Causes of isolat...
Post a Comment
Read more