Aplastic Anemia, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications

Aplastic Anemia, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications

Aplastic anemia is a condition when the bone marrow is unable to produce enough new blood cells. This disease causes the number of one or all types of red blood cells to decrease. Aplastic anemia can affect anyone, but it is more common in people in their early 20s and the elderly. Early symptoms of aplastic anemia are easy fatigue, pale skin, shortness of breath, and dizziness. Patients with this condition are also susceptible to infection due to a lack of leukocytes or white blood cells (leukopenia).

Causes of Aplastic Anemia

Aplastic anemia occurs because the stem cells in the bone marrow are damaged. This stem cell damage causes blood cell production to slow down or even decrease. As a result, the number of red blood cells (erythrocytes), white blood cells (leukocytes), and platelets (platelets) is reduced.

Some conditions or diseases that can cause aplastic anemia are:
• Autoimmune disease
Autoimmune diseases occur when the body's immune system attacks healthy cells, including stem cells in the bone marrow. If not treated immediately, the risk of developing aplastic anemia will increase.
• Genetic disorders
A person can get aplastic anemia if they have a family history of a similar disease. In addition, a genetic disorder called Fanconi anemia can also cause this disease.
• Viral infections
Viral infections that attack the bone marrow can also cause aplastic anemia. Several types of viruses that are often associated with aplastic anemia are Hepatitis, Epstein-Barr, Cytomegalovirus, Parvovirus B19 (human parvovirus), and human immunodeficiency virus (HIV).
• Radiotherapy and chemotherapy
Radiotherapy and chemotherapy are types of therapy to treat cancer. This method has the risk of side effects, including damaging stem cells in the bone marrow and increasing the risk of aplastic anemia.
• Use of certain drugs
Certain medications, such as the antibiotic chloramphenicol and drugs to treat rheumatoid arthritis, can cause bone marrow damage and increase the risk of aplastic anemia.
• Exposure to chemicals
Continuous exposure to chemicals, such as pesticides, insecticides, and benzene, can also cause aplastic anemia.
• Pregnancy
Pregnancy sometimes makes the immune system of pregnant women attack and damage the bone marrow.

In addition to the conditions described, aplastic anemia can be caused by unknown factors. This condition is often referred to as idiopathic aplastic anemia.

Symptoms of Aplastic Anemia

Each type of blood cell has a different function. Leukocytes play a role in the body's immunity, while platelets play an important role in the process of blood clotting. Meanwhile, erythrocytes contain hemoglobin so that it plays a role in distributing oxygen and nutrients throughout the body.

Symptoms of aplastic anemia can vary, depending on the function of the blood cells that are affected. However, the common symptoms are:

• Easily tired and weak
• Hard to breathe
• Pale skin
• Dizzy
• Headache
• Fever
• Skin easily bruises or bleeds
• Recurrent infections and long recovery
• Nosebleeds

When to go to the doctor
Immediately consult a doctor if you experience the above symptoms. You are also advised to seek medical attention immediately if you experience bleeding that is difficult to stop or infections that are recurrent and difficult to heal.

Diagnosis of Aplastic Anemia

To diagnose aplastic anemia, the doctor will ask questions about the complaints experienced, the patient's and family's disease history, as well as the drugs being consumed, followed by a physical examination.

After that, to confirm the diagnosis, the doctor will carry out supporting examinations in the form of:
• Blood test
Blood tests are done to see the levels of red cells, white blood cells, platelets, and hemoglobin. Patients are suspected of having aplastic anemia if the number of one or all of the cells is below normal limits.
• Bone marrow biopsy
A bone marrow biopsy is performed by taking a sample of bone marrow to be examined under a microscope. This examination is also done to rule out other possible causes.

Aplastic Anemia Treatment

Treatment of aplastic anemia depends on the condition and severity of the patient. The following are the types of treatment for aplastic anemia:

1. Antibiotics and antivirals
Patients with aplastic anemia are susceptible to infection. Therefore, antibiotics or antivirals will be given by the doctor to treat the infection.

2. Blood transfusion
If the level and number of blood cells is reduced drastically, blood transfusions can be given to relieve symptoms and meet the needs of blood cells.

3. Immunosuppressants
Immunosuppressant drugs are given to suppress the activity of the immune system that damages the bone marrow. Immunosuppressants will be given to patients with aplastic anemia due to autoimmune diseases. Several types of drugs used are ciclosporin or corticosteroids.

4. Stem cell transplant
A stem cell transplant or bone marrow transplant is performed to replace damaged cells with healthy cells. This method is usually performed on patients under the age of 40 years and get a suitable donor, such as a sibling.

This method can also be used in patients whose symptoms do not improve after using immunosuppressants. However, this procedure is also risky if the patient's body rejects stem cells from donors.

5. Bone marrow stimulant
Administration of drugs, such as filgrastim, pegfilgrastim, and epoetin alfa, can be done to stimulate the bone marrow to produce new blood cells. This method is often combined with the administration of immunosuppressants.

Complications of Aplastic Anemia

If not treated, aplastic anemia can cause complications such as:

• Severe infection
• Bleeding
• Accumulation of iron in the body (hemochromatosis)
• Myelodysplastic syndrome
• Blood cancer (leukemia)
• Cancer of the lymph nodes (lymphoma)

Prevention of Aplastic Anemia

There is no way to prevent aplastic anemia. However, to reduce the risk of developing aplastic anemia, you should avoid exposure to chemicals, such as pesticides, insecticides, organic solvents, and paint removers.

If you have aplastic anemia, there are several things you can do to prevent this condition from getting worse or causing complications, namely:

• Medication and regular check-ups with the doctor
• Wash your hands regularly, especially after using the toilet or doing outdoor activities
• Avoid sports that involve physical contact, to prevent bleeding
• Adequate rest time after activities and a good night's sleep
• Complete immunizations, especially for children, by consulting a doctor first

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