Aplastic anaemia

Last updated: Thursday, 28, October, 2010
CausesAppropriate Tests

FBC, blood film, reticulocyte count.

Marrow aplasia or hypoplasia is characterised by the finding of pancytopenia.

The diagnosis is established by bone marrow aspirate and matrephine biopsy which are indicated unless the aplasia is a predictable effect of drugs and/or irradiation.

There is broad overlap in pathogenesis, laboratory features and therapy with Paroxysmal Nocturnal Haemoglobinuria (PNH) and hypoplastic MDS.

See also Anemia normochromic, macrocytic and Pancytopenia

Chemical agents

Predictable

Agents that commonly cause aplasia in commonly used dosis or normal exposure.

  • Cytotoxic drugs

Susceptibility to azathioprine and 6-mercaptopurine is increased in patients with thiopurine methyltransferase deficiency.

  • Irradiation 

Idiosyncratic

  • Antithyroid medication
  • Chloramphenicol
  • Sulphonamides
  • NSAID, especially Phenylbutazone, indomethacin, ibuprofen, sulindac.
  • Gold
  • Insecticide exposure
  • Anticonvulsants, especially hydrantoins, carbimozapine
  • Zidovudine (AZT)
  • Benzene

Relative low probability in a drug of common use.

Viral infection

Viral Hepatitis

See Hepatitis

Congenital

Fanconi's anaemia 

Inherited aplestite anaemia. Cytogenetics (non-oncology); molecular genetics.

Other

Thymoma 

Association with pure red cell aplasia; see Mediastinal mass.

Idiopathic

Linked all-surface proteins.

Paroxysmal nocturnal haemoglobinuria

Flow cytometry assessment of glycophosphatidy inositol (GPI).