Aplastic anemia occurs when the bone marrow produces too few of all types of blood cells: red cells, white cells, and platelets. A reduced number of red blood cells causes the hemoglobin (a type of protein in the red blood cells that carries oxygen to the tissues of the body) to drop. A reduced number of white blood cells causes the patient to be susceptible to infection. A reduced number of platelets can cause the blood not to clot as easily. Aplastic anemia in children has multiple causes. Some of these causes are idiopathic, meaning they occur sporadically for no known reason. Other causes are secondary, resulting from a previous illness or disorder.
Nearly 50 to 75 percent of childhood cases of aplastic anemia occur sporadically for no known reason. Acquired causes, however, may include:
history of specific infectious diseases such as hepatitis, Epstein-Barr virus (EBV), cytomegalovirus (CMV), parvovirus B19, or human immunodeficiency virus (HIV)
history of taking certain medications
exposure to certain toxins such as heavy metals
exposure to radiation
history of an autoimmune disease such as lupus
Children may also inherit a disorder that predisposes them to developing aplastic anemia. Some disorders that are known to predispose a child to aplastic anemia include the following:
Fanconi anemia
dyskeratosis congenita
Shwachman-Diamond syndrome
reticular dysgenesis
amegakaryocytic thrombocytopenia
familial aplastic anemias
Symptoms
The following are the most common symptoms of aplastic anemia. However, each child may experience symptoms differently. Symptoms may include:
headache
dizziness
nausea
shortness of breath
bruising
lack of energy or tiring easily (fatigue)
abnormal paleness or lack of color of the skin
blood in stool
nosebleeds
bleeding gums
fevers
sinus tenderness
enlarged liver or spleen
oral thrush (white patches on a red, moist, swollen surface, occurring anywhere in the mouth)
The symptoms of aplastic anemia may resemble other blood disorders or medical problems. Always consult your child's physician for a diagnosis.
Diagnosis In addition to a complete medical history and physical examination of your child, diagnostic procedures for aplastic anemia may include:
blood tests
bone marrow aspiration and biopsy - marrow may be removed by aspiration or a needle biopsy under local anesthesia. In aspiration biopsy, a fluid specimen is removed from the bone marrow. In a needle biopsy, marrow cells (not fluid) are removed. These methods are often used together.
Treatment
Specific treatment for aplastic anemia will be determined by your child's physician based on:
your child's age, overall health, and medical history
the extent of the anemia
cause of the anemia
your child's tolerance for specific medications, procedures, or therapies
expectations for the course of the anemia
your opinion or preference
Aplastic anemia is a serious illness and treatment usually depends on the underlying cause. For certain causes, recovery can be expected after treatment, however, relapses can occur. To treat the low blood counts, initially treatment is usually supportive, meaning that it is necessary to treat the symptoms but not possible to cure the disease. Supportive therapy may include:
blood transfusion (both red blood cells and platelets)
preventative antibiotic therapy
meticulous handwashing
special care to food preparation (such as only eating cooked foods)
avoiding construction sites which may be a source of certain fungi
medications (to stimulate the bone marrow to produce cells)
immunosuppressive therapy
hormones
Prevention
Activities which put children with aplastic anemia at risk for infection or bleeding should be avoided. These activities include the following:
dental work (until your child's white blood cell counts rise)
contact sports (i.e., football, hockey, skiing, or rollerblading)
traveling to high altitudes (children with a low red blood cell count will have increased fatigue and need for oxygen in high altitudes)
If a child has a relapse of aplastic anemia, additional treatment (including a possible bone marrow transplant) may be necessary
Draligus Health Disclaimer: Health Information Encyclopedia is a health encyclopedia for educational purposes, but does not provide medical - health information, medical diagnosis or medical treatment for your patients.
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