The signs and symptoms of aplastic anemia have to do with
the diminished production of these different blood cells.
Let's talk about the diminished
red blood cells or anemia.
Signs and symptoms consistent with anemia
are: fatigue, shortness of breath with exertion,
rapid or irregular heart rate as the patient
tries to quickly move the blood around,
pale skin, dizziness and headache.
Signs and symptoms associated with the
low white blood cell count or neutropenia
would be frequent or prolonged infection.
And finally the signs and symptoms of low platelets or
thrombocytopenia include unexplained or easy bruising,
patients get recurrent or long nose bleeds and bleeding
gums, and then prolonged bleeding from their cuts.
Tthere is a stepwise approach to the evaluation
of a patient suspected of having aplastic anemia.
First a patients personal and family
medical histories will be gathered.
Patients of concern for having aplastic anemia
will usually have signs and symptoms of anemia.
They will usually have frequent infections
and they will have easy bleeding or bruising.
This constellation of symptoms will increase
your clinical suspicion for aplastic anemia.
Then the clinician will perform a
physical exam to assess the patient.
This includes interpretation of the vital signs and
assesment of the cardiac and respiratory systems
as well as evaluation of the skin
to check for pallor or bruising.
You can do a complete blood count and this
is gonna show a low count of red blood cells,
white blood cells and platelets
Now these cells are gonna be normocytic and
normochromic because the cells are normal size
and have a normal amount of
hemoglobin, they just aren't enough.
Remember aplastic anemia is
an issue of quantity not quality.
You can do a bone marrow biopsy
and this will help confirm the diagnosis.
In this procedure, a clinician uses a needle
to remove a small sample of bone marrow
from a large bone in the patient's body, usually
in the pelvis called the posterior iliac crest.
The bone marrow sample's going to be examined under
a microscope to rule out other blood related diseases.
In aplastic anemia, the bone marrow will
be hypocellular since fewer cells are present
and there will not be any malignant infiltrates
because this is not a cancerous condition.