Aplastic anemia: symptoms. Diagnosis and treatment of aplastic anemia

In our time, there is a large number of a variety of diseases that are directly related to blood. One such is aplastic anemia. Symptoms of this ailment do not occur immediately. Is it possible to cure this disease? What preventive measures exist? This is exactly what will be discussed in this article.

General information

Aplastic anemia is a disease of the hematopoietic system, in which there is a sharp decrease in the number of all blood cells, but without obvious signs of a tumor process. According to experts, this pathology is rare. May be both men and women can suffer, more often after 50 years. In the absence of timely treatment, aplastic anemia often leads to death.

Mechanism of disease development

As is known, hematopoiesis is carried out by means of a special group of cells, namely hematopoietic stem cells. They have the ability to multiply and differentiate into various germs of hematopoiesis. It is from the latter that mature cells (erythrocytes, leukocytes, platelets and others) are formed. Under the influence of a number of external or internal factors, the following mechanisms of sequential development of the disease are possible:

• The number of hematopoietic stem cells is gradually decreasing;
• The primary function of stem cells is violated, which entails the inability to form red blood cells, platelets and leukocytes;

The defeat of the stem cell in this case is confirmed by the effectiveness of bone marrow transplantation from identical twins or siblings. This is how aplastic anemia is treated in children and adults. However, transplantation is ineffective from an identical twin in the event that the recipient has not previously received a course of drugs to suppress immunity. It is this fact that most often confirms the immune nature of the disease.

Main reasons

Unfortunately, the etiological factors of the development of the disease are not completely known. Experts believe that such may be:

• Regular contact with some groups of chemicals;
• Alcohol abuse;
• Genetic predisposition;
• Ionizing radiation;
• Intoxication of the body with medicinal preparations;
• Some infectious diseases;

If specialists can not establish a direct link with the causes listed above, the disease is called idiopathic aplastic anemia.

Symptoms

• Pale skin, bruising.
• Dyspnea.
• Raise body temperature.
• Weakness, fatigue, dizziness.
• Tachycardia.
• Ulcerative stomatitis.
• Nasal or gingival hemorrhages.
• Decreased appetite, a sharp weight loss.

This is not all the clinical signs, as can manifest aplastic anemia. Symptoms, of course, differ in each case. Moreover, they often resemble other diseases of the hematopoietic system. That is why it is so important to seek help from a doctor in a timely manner and hand over all the necessary tests. There are certain blood levels for each sex and age. If, for example, the biochemistry indicators are slightly different, the doctor will already prescribe a more detailed examination, and then the appropriate treatment.

Forms

Experts conventionally classify this disease by origin into two types:

1. Congenital aplastic anemia happens:

• Hereditary (hematopoiesis and congenital malformations) Fanconi anemia;
• Hereditary (hematopoiesis without congenital anomalies in development) anemia of Estrena-Dameshek;
• Partial red cell aplasia (decrease in the number of erythrocytes);

2. Acquired aplastic anemia can be:

• With a common lesion of hemopoiesis;
• With selective lesion of erythropoiesis;

In addition, the disease is classified by severity:

• Not severe aplastic anemia. The blood test shows high levels of some components, but this is not enough compared to the norm.
• Severe aplastic anemia. Underestimation of platelets, rickulocytes and granulocytes.

What is the difference between anemia and posthemorrhagic anemia?

This is a fairly common type of anemia that occurs because of severe blood loss, which leads to a sharp decrease in hemoglobin in the blood, the development of so-called vascular insufficiency and oxygen starvation. For a normal adult, the danger occurs if the blood loss exceeds the volume of 500 ml.

This pathology, as a rule, occurs with ectopic pregnancy, blood or liver diseases, severe blood loss after trauma or surgical intervention.

It is noteworthy that a patient can not suspect for a few days the presence of this problem. Brightly pronounced symptoms appear 2-3 days after hemorrhage. If the patient is not provided with qualified care, the likelihood of a lethal outcome is very high.

Such a problem, as anemia posthemorrhagic, is treatable. The doctor first of all must eliminate the main source of blood loss and perform a transfusion of colloidal solutions.

Diagnostics

Most often, suspicion of the disease occurs after the next delivery of tests for preventive purposes. With anemia in the blood, the content of erythrocytes, leukocytes and hemoglobin are reduced, and the level of ESR is sharply increased. It is important to note that the degree of reduction in the content of these or other components can vary in each individual case.

To confirm the disease, aplastic anemia blood test is not the only method of diagnosis. The doctor, as a rule, appoints a more detailed examination of the patient, which includes:

• Physical examination (determination of skin color, blood pressure, presence of hemorrhages, etc.);
• Urinalysis (the presence of blood is considered a sign of hemorrhagic syndrome, and the presence of microorganisms is a manifestation of complications of infectious nature);
• Biochemical blood test (cholesterol, glucose, uric acid level);
• A complete history (whether there are bad habits, whether there are any chronic diseases, whether there was contact with toxic substances);
• blood test;
• Examination of bone marrow by puncture;
• Electrocardiography;

What should be the treatment?

First of all, it should be noted that only a qualified approach can help the patient in the fight against a disease such as aplastic anemia. Symptoms of this ailment in the early stages should alert everyone. Moreover, with the appearance of primary clinical signs it is important to immediately seek help from a doctor for a detailed examination.

Modern medicine offers three options for therapy. Below, we will discuss each in more detail.

1. Etiotropic treatment is recommended in the event that the cause of anemia is known. In this situation, the main goal of therapy is to directly influence the provoking factor, but it often turns out to be ineffective. Patients are recommended to exclude the main cause of the disease (removal of the radiation zone, the cancellation of certain medications, etc.). Such measures only reduce the rate of death of the bone marrow itself, but do not restore blood norms.
2. Pathogenic treatment implies the elimination of the mechanisms of development of the disease. For these purposes, immunosuppressive therapy (preparations "Cyclophosphamide", "Cyclosporine") is used. In some cases, the use of these drugs can fully restore the function of hemopoiesis. Also in the treatment are used corticosteroids and anabolic steroids. These drugs not only stimulate the formation of leukocytes, but also enhance protein synthesis. In severe cases, doctors recommend bone marrow transplantation. The effectiveness of the operation is much higher in young patients. Aplastic anemia in children is also treated by transplantation.
3. Symptomatic therapy is used to combat specific manifestations of the disease. It includes the transfusion of the main components of the blood, antibacterial (medicines "Fluconazole", "Norfloxacin") and systemic antifungal therapy.

Complications and consequences

• Anemic coma. Because of the rapid decrease in red blood cells in the blood, the brain practically does not receive oxygen, as a result, the person loses consciousness and does not react to external stimuli.
• Infections.
• Hemorrhagic complications (bleeding). The most terrible problem is a so-called hemorrhagic stroke, when part of the brain dies due to impregnation with its blood.
• Deterioration of some internal organs (most often occurs in the presence of chronic diseases).

As mentioned above, an exceptionally qualified treatment helps to overcome such a pathology as aplastic anemia. The prognosis is most often favorable, but only with timely access to a doctor. According to available statistical data, without appropriate therapy, about 90% of patients die within one year.

The most effective method of treatment is bone marrow transplantation. So, 9 out of 10 patients after the operation live more than five years.

With the impossibility of surgical intervention (exclusively medical therapy) for more than five years only half of the patients can live, and up to 40 years.

Prevention

Primary prevention involves actions to prevent the negative impact on the body of various external factors. Here we are talking about the observance of elementary safety techniques when interacting with sources of ionizing radiation, dyes. In addition, it is important to monitor the intake of drugs and their dosage.

Secondary prevention (prevention of worsening of the already sick person) implies a regular follow-up, as well as long-term maintenance treatment.

In conclusion, it should be noted that one should not be afraid of such a diagnosis as aplastic anemia. Photos of healthy people who have suffered this disease, prove that it is possible to combat the problem. In this case, a special role belongs to the timeliness of applying for qualified care and the strict adherence to all recommendations from doctors. Be healthy!