Aplastic Anemia

Published on 04/03/2015 by admin

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Last modified 04/03/2015

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Chapter 4 Aplastic Anemia

Neal S. Young, Jaroslaw P. Maciejewski

Table 4-1 Differential Diagnosis of Pancytopenia

Pancytopenia With Hypocellular Bone Marrow
Acquired aplastic anemia Inherited aplastic anemia (Fanconi anemia and others) Some myelodysplasia syndromes Rare aleukemic leukemia (acute myeloid leukemia) Some acute lymphoblastic leukemias Rare lymphomas of bone marrow
Pancytopenia With Cellular Bone Marrow
Primary bone marrow diseases Myelodysplasia syndromes Paroxysmal nocturnal hemoglobinuria Myelofibrosis Some aleukemic leukemias Myelophthisis Bone marrow lymphoma Hairy cell leukemia Secondary to systemic diseases Systemic lupus erythematosus, Sjögren syndrome Hypersplenism Vitamin B₁₂, folate deficiency (familial defect) Overwhelming infection Alcohol Brucellosis Ehrlichiosis Sarcoidosis Tuberculosis and atypical mycobacteria
Hypocellular Bone Marrow ± Cytopenia
Q fever Legionnaires disease Mycobacteria Tuberculosis * Anorexia nervosa, starvation Hypothyroidism

^*Pancytopenia in tuberculosis only rarely is associated with a hypocellular bone marrow at biopsy or autopsy. Marrow failure in the setting of tuberculosis is almost always fatal; exceptional patients probably had underlying myelodysplasia or acute leukemia.

Table 4-2 A Classification of Aplastic Anemia

Acquired Aplastic Anemia
Secondary aplastic anemia Irradiation Drugs and chemicals Regular effects Cytotoxic agents Benzene Idiosyncratic reactions Chloramphenicol Nonsteroidal antiinflammatory drugs Antiepileptics Gold Other drugs and chemicals Viruses Epstein-Barr virus (infectious mononucleosis) Hepatitis virus (non-A, non-B, non-C, non-G hepatitis) Parvovirus (transient aplastic crisis, some pure red blood cell aplasia) Human immunodeficiency virus (acquired immunodeficiency syndrome) Immune diseases Eosinophilic fasciitis Hyperimmunoglobulinemia Thymoma and thymic carcinoma Graft-versus-host disease in immunodeficiency Paroxysmal nocturnal hemoglobinuria Pregnancy Idiopathic aplastic anemia
Inherited Aplastic Anemia
Fanconi anemia Dyskeratosis congenita Shwachman-Diamond syndrome Reticular dysgenesis Amegakaryocytic thrombocytopenia Familial aplastic anemias Buy Membership for Hematology, Oncology and Palliative Medicine Category to continue reading. Learn more here

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