Anemia Aplásica

Epidemiología y Etiología

Epidemiología

• Incidencia variable Variable Variables represent information about something that can change. The design of the measurement scales, or of the methods for obtaining information, will determine the data gathered and the characteristics of that data. As a result, a variable can be qualitative or quantitative, and may be further classified into subgroups. Types of Variables a nivel mundial
  • Incidencia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum Europa: 2,35 por 1 millón
  • Incidencia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum Asia ASIA Spinal Cord Injuries: 7 por 1 millón
• Sin preferencia de sexo
• Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica adquirida: distribución de edad bifásica → pico principal en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la adolescencia a los LOS Neisseria veinte años; 2do pico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ancianos

Etiología

Condiciones heredadas:

• Defecto(s) intrínseco(s) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las células madre hematopoyéticas
• Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types de Fanconi:
  • Herencia autosómica recesiva
  • Incapacidad para reparar ciertos tipos de daños en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el ADN.
  • El daño celular ocurre en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum múltiples tipos de células, incluidas las células madre hematopoyéticas.
• Disqueratosis congénita: un síndrome de la biología de los LOS Neisseria telómeros con diferentes patrones de herencia que involucran múltiples genes Genes A category of nucleic acid sequences that function as units of heredity and which code for the basic instructions for the development, reproduction, and maintenance of organisms. DNA Types and Structure diferentes
• Síndrome de Shwachman-Diamond: mutaciones genéticas que afectan la biogénesis y la mitosis Mitosis A type of cell nucleus division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. Cell Cycle de los LOS Neisseria ribosomas
• Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types de Diamond-Blackfan: mutaciones genéticas que afectan la síntesis de ribosomas
• Trisomía 21/síndrome de Down: puede provocar múltiples trastornos hematológicos ( anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica con menos frecuencia que las enfermedades mieloproliferativas o la leucemia)

Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplasica adquirida:

• Autoinmune u otros tipos de daño a las células madre hematopoyéticas
• Idiopática:
  • La mayoría de los LOS Neisseria casos (80%–85%)
  • Inmunomediada: mayor número de clones de células T citotóxicas activadas
• Medicamentos y otros agentes:
  • Alopurinol
  • Antihistamínicos
  • Agentes antitiroideos
  • Antiprotozoarios
  • Anticonvulsivos
  • Medicamentos quimioterapéuticos citotóxicos
  • Cloranfenicol
  • D-penicilamina
  • AINE
  • Sulfonamidas
  • Otros agentes
    • Benceno
    • Estrógenos
    • Metales pesados: oro, arsénico, bismuto, mercurio
• Radiación a todo el cuerpo:
  • Accidentes nucleares → daño directo al AL Amyloidosis ADN
  • Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica es una secuela aguda.
  • La mielodisplasia y la leucemia son efectos tardíos.
• Los LOS Neisseria virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology pueden alterar los LOS Neisseria antígenos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las células madre activando un clon de células T citotóxicas o iniciando la liberación de citoquinas por parte de las células T:
  • EBV EBV Epstein-barr virus (EBV) is a linear, double-stranded DNA virus belonging to the herpesviridae family. This highly prevalent virus is mostly transmitted through contact with oropharyngeal secretions from an infected individual. The virus can infect epithelial cells and B lymphocytes, where it can undergo lytic replication or latency. Epstein-Barr Virus
  • CMV
  • Virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de la inmunodeficiencia humana (VIH)-1, SIDA
  • Parvovirus B19 Parvovirus B19 Primate erythroparvovirus 1 (generally referred to as parvovirus B19, B19 virus, or sometimes erythrovirus B19) ranks among the smallest DNA viruses. Parvovirus B19 is of the family Parvoviridae and genus Erythrovirus. In immunocompetent humans, parvovirus B19 classically results in erythema infectiosum (5th disease) or “slapped cheek syndrome.” Parvovirus B19 ( anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica transitoria, más comúnmente causa aplasia Aplasia Cranial Nerve Palsies pura de eritrocitos)
  • Hepatitis seronegativa (probablemente debido a un virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology aún desconocido)
• Enfermedades inmunitarias (e.g., fascitis eosinofílica, timoma)
• Evolución clonal (la anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica puede estar asociada a otro trastorno hematológico):
  • Hemoglobinuria Hemoglobinuria The presence of free hemoglobin in the urine, indicating hemolysis of erythrocytes within the vascular system. After saturating the hemoglobin-binding proteins (haptoglobins), free hemoglobin begins to appear in the urine. Transfusion Reactions paroxística nocturna (HPN):
    • Aproximadamente el 50% de los LOS Neisseria pacientes con anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica muestran una población clonal expandida con el defecto de HPN por citometría de flujo.
    • Aproximadamente el 15% de los LOS Neisseria pacientes con HPN desarrollan pancitopenia a los LOS Neisseria 8 años.
  • Síndrome mielodisplásico
  • Leucemia mieloide aguda
• Embarazo

Fisiopatología

Hematopoyesis normal

• Al AL Amyloidosis nacer: La hematopoyesis está presente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum todo el esqueleto, con islas de hematopoyesis residual que quedan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hígado durante 1 mes.
• Después de la pubertad: La hematopoyesis cesa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria huesos distales y se restringe al AL Amyloidosis esqueleto axial Axial Computed Tomography (CT) (cráneo, esternón, costillas, vértebras, cabeza del húmero y fémur y pelvis Pelvis The pelvis consists of the bony pelvic girdle, the muscular and ligamentous pelvic floor, and the pelvic cavity, which contains viscera, vessels, and multiple nerves and muscles. The pelvic girdle, composed of 2 “hip” bones and the sacrum, is a ring-like bony structure of the axial skeleton that links the vertebral column with the lower extremities. Pelvis: Anatomy).
  • En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum adultos normales, solo alrededor de la mitad del espacio de la médula es hematopoyéticamente activo (médula roja); la médula inactiva es grasa (médula amarilla).
  • La celularidad de la médula ósea disminuye un 10% cada década.

Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica

• Sangre periférica:
  • Disminución en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las 3 líneas celulares, e.g., leucocitos, eritrocitos y plaquetas (= pancitopenia)
  • No hay presencia de células anormales (e.g., displásicas o leucémicas) ni evidencia de hemólisis
• Médula ósea: hipocelular para la edad; sin células anormales o fibrosis Fibrosis Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. Bronchiolitis Obliterans de la médula
• Varios grados de severidad

Presentación Clínica

• Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types: palidez, cefalea, palpitaciones, disnea, fatiga
• Trombocitopenia: hemorragia mucosa y gingival o erupciones petequiales
• Neutropenia Neutropenia Neutrophils are an important component of the immune system and play a significant role in the eradication of infections. Low numbers of circulating neutrophils, referred to as neutropenia, predispose the body to recurrent infections or sepsis, though patients can also be asymptomatic. Neutropenia: infecciones manifiestas, infecciones recurrentes, fiebre, úlceras orofaríngeas
• Puede haber malformaciones congénitas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria trastornos hereditarios asociados

Diagnóstico

Historia y examen físico

• Compruebe si hay exposición a medicamentos o productos químicos.
• Compruebe si hay infección viral.
• Antecedentes familiares: citopenias y/o hallazgos somáticos sugestivos de un trastorno hereditario
• Hallazgos físicos:
  • Asociado con pancitopenia, especialmente palidez y petequias
  • Complicaciones de las citopenias (e.g., sistema cardiovascular, infecciones)
  • Manifestaciones de trastornos hereditarios (e.g., hallazgos cutáneos/ungueales, baja estatura, anomalías esqueléticas o genitourinarias, hallazgos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ojos/oídos)
  • El agrandamiento del hígado, el bazo o los LOS Neisseria ganglios linfáticos sugiere un resultado negativo para anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica.

Biopsia de médula ósea

Pancitopenia con médula ósea hipocelular que muestra:

• Sin infiltrados anormales (sin blastos leucémicos o evidencia de anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types megaloblástica)
• Sin fibrosis Fibrosis Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. Bronchiolitis Obliterans de la médula (como se ve VE Ventilation: Mechanics of Breathing en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria trastornos mieloproliferativos)
• Sin displasia mieloide (como se ve VE Ventilation: Mechanics of Breathing en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el síndrome mielodisplásico)
• ¡Solo se puede suprimir 1 línea celular antes de que llegue la pancitopenia profunda!

Estudios de laboratorio

• Electrolitos, pruebas de función hepática, lactato deshidrogenasa, pruebas de función renal
• Nivel sérico de vitamina B12 y folato en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum eritrocitos para descartar anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types megaloblástica
• Citometría de flujo para detectar HPN (ausencia de CD59 y CD55 en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las células sanguíneas)
• Pruebas citogenéticas y moleculares de la médula ósea para excluir ciertos trastornos hereditarios

Categorías de gravedad

• Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica grave:
  • Celularidad de la médula ósea < 25%
  • Al AL Amyloidosis menos 2 de los LOS Neisseria siguientes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hemograma periférico:
    • Recuento absoluto de neutrófilos < 500/μL
    • Recuento de plaquetas < 20 000/μL
    • Recuento de reticulocitos < 20 000/μL
• Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica muy grave:
  • Cumple criterios de anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica grave
  • Recuento absoluto de neutrófilos < 200/μL
• Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica no grave: hipocelularidad de la médula ósea y citopenias en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum sangre periférica que no cumplen criterios de anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica grave o muy grave

Tratamiento

Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica moderada

• Eliminar posibles medicamentos o agentes causales.
• Transfusiones y terapia antiinfecciosa si es necesario
• Espere para tratar, ya que puede ocurrir una remisión espontánea (si es causada por un virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology o un medicamento).
• Tratar si la anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica se transforma en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum una forma más grave o se vuelve dependiente de transfusiones.

Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica severa

• Eliminar posibles medicamentos o agentes causales.
• Transfusiones y terapia antiinfecciosa si es necesario
• Si es menor de 50 años y médicamente apto:
  • Triple terapia: incluye 2 inmunosupresores + 1 estimulante de la médula ósea
    • Globulina antitimocito de caballo
    • Ciclosporina
    • Eltrombopag Eltrombopag Hematopoietic Growth Factors (agonista del receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors de trombopoyetina)
  • Trasplante alogénico de células hematopoyéticas
• Si tiene > 50 años o no está médicamente apto: solo terapia triple

Diagnóstico Diferencial

• Supresión reversible de la médula ósea: efectos predecibles y dependientes de la dosis de la quimioterapia citotóxica, radioterapia accidental, sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock grave o infección viral aguda. El diagnóstico se realiza mediante la toma de antecedentes, las pruebas microbiológicas y las pruebas serológicas. Se espera que los LOS Neisseria recuentos sanguíneos mejoren en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum días o semanas.
• Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types megaloblástica: por deficiencias de vitamina B12 ( anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types perniciosa) y/o folatos (desnutrición). El frotis de sangre periférica muestra neutrófilos y macroovalocitos hipersegmentados; la médula ósea muestra megaloblastos. Los LOS Neisseria niveles séricos bajos de vitamina B12 (o ácido metilmalónico) y/o folato pueden confirmar el diagnóstico. El paciente se trata con suplementos vitamínicos.
• Trastornos infiltrativos de la médula ósea: pueden deberse a fibrosis Fibrosis Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. Bronchiolitis Obliterans (e.g., mielofibrosis), neoplasias malignas o agentes infecciosos (e.g., tuberculosis Tuberculosis Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis complex bacteria. The bacteria usually attack the lungs but can also damage other parts of the body. Approximately 30% of people around the world are infected with this pathogen, with the majority harboring a latent infection. Tuberculosis spreads through the air when a person with active pulmonary infection coughs or sneezes. Tuberculosis, hongos). El frotis de sangre periférica a menudo muestra células de forma anormal (poiquilocitos), células en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de lágrima y cambios leucoeritroblásticos (i.e., tanto leucocitos inmaduros como eritrocitos inmaduros/nucleados). La médula ósea generalmente es diagnóstica de casos infecciosos o anormalidades observadas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum tumores malignos.
• Hiperesplenismo: las citopenias debidas al AL Amyloidosis secuestro asociado con la esplenomegalia pueden ser causadas por cirrosis hepática, trombosis de la vena porta y trastornos infiltrativos de la médula ósea. La citopenia no es tan grave como la que se observa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica u otros trastornos. El examen de médula ósea revela actividad hematopoyética normal o aumentada.
• Síndrome mielodisplásico: suele mostrar una médula llena con citopenia periférica. La médula ósea muestra cambios displásicos celulares y/o anomalías citogenéticas o moleculares características del síndrome mielodisplásico. El síndrome mielodisplásico puede responder a la misma terapia triple utilizada para anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica.
• Leucemia de linfocitos granulares grandes: una leucemia caracterizada por citopenias, esplenomegalia e infiltración de sangre periférica y médula ósea por linfocitos granulares grandes, que pueden coexistir con anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types aplásica. El diagnóstico es posible con citometría de flujo y pruebas moleculares.