Aplastic anemia

Aplastic anemia is primarily a blood disorder in which the body's bone marrow fails to produce sufficient blood cells for circulation. It is a rare acquired disorder which is neither present at birth nor inherited but is developed later on.

The bone marrow is a sponge-like tissue inside the bones that makes vital stem cells which then further develop into red blood cells, white blood cells and platelets. People suffering from Aplastic anemia not only have low red blood cell count but they also lack in white blood cells and platelets, as bone marrow stem cells are damaged; this disorder is termed as pancytopenia.  Aplastic anemia is also referred to as bone marrow failure. It is more common in younger people but it can develop at any age.  

Aplastic anemia is a rare but serious condition that can result in various health complications such as arrhythmias, enlarged heart or even heart failure. It can be moderate or very severe. People with severe Aplastic anemia are at risk for life-threatening infections or bleeding.Acquired Aplastic anemia may be caused by toxic chemicals, radiation or by idiosyncratic reactions or infections. In some cases there is no identifiable cause and the condition is then referred to as idiopathic Aplastic anemia.

Recent studies have reported that in the United States about 500-1,000 people develop Aplastic anemia every year.  Worse, in Asian countries the number of people affected by Aplastic anemia goes up by goes two to three times.

Aplastic anemia is a condition that can develop suddenly or slowly. But if not diagnosed in time and without proper treatment the disorder can assume serious proportions.  With increasing research and advent of medicines, Aplastic anemia can today be successfully overcome. Some cures for Aplastic anemia include stem cell transplants, blood or bone marrow transplants, and even blood transfusions.

Aplastic anemia causes

Aplastic anemia occurs when the bone marrow produces insufficient blood cells: red cells, white cells and platelets. This disorder causes the hemoglobin level in the blood to drop due to low count of these blood cells. Lack in hemoglobin can lessen the oxygen binding ability of each hemoglobin molecule, resulting in anemia. Aplastic anemia has many causes and can occur for no known reason (idiopathic aplastic anemia) or from a previous illness or disorder. The disease is not contagious and although more common among younger people it can affect patients of any age.

• High-dose radiation and chemotherapy treatments help in killing cancer cells but they also damage healthy cells, including stem cells in bone marrow which may lead to Aplastic anemia.
• Auto immune disorders are also one of the main causes of Aplastic anemia.  An autoimmune disorder such as lupus is a condition where the immune system begins attacking healthy cells and stem cells in the bone marrow. Mothers suffering from Aplastic anemia during pregnancy may be related to an autoimmune disorder as stem cells in the bone marrow are targeted by the immune system itself.
• Certain viral infections such as hepatitis, Epstein- Barr, cytomegalovirus, parvovirus B-19 and HIV affect bone marrow and play a major role in the development of Aplastic anemia in some people.
• Exposure to toxic chemicals may cause Aplastic anemia and these toxic chemicals are generally used in some insecticides and pesticides. Benzene is a carcinogen and toxic substance that when inhaled or ingested for a long period of time may leave lethal effects on the body.
• Use of certain drugs or medications which are essential in the treatment of rheumatoid arthritis can cause Aplastic anemia.
• Paroxysmal nocturnal haemoglobinuria is a rare immune system disorder which destroys red blood cells and forms defective platelets and is mainly caused due to Aplastic anemia. Around 30% of the people with Aplastic anemia have this rare disorder.
• A rare immune disorder known as Fanconi’s anemia is an inherited disease which generally leads to Aplastic anemia. Children born with this disorder have stunted growth and underdeveloped limbs.

Aplastic anemia symptoms

A low red blood cell count can cause reduction in the oxygen delivery to every tissue in the body. There are many signs and symptoms associated with Aplastic anemia. Some common symptoms include

• weakness
• lack of physical energy
• fatigue
• headaches
• shortness of breath
• lightheadedness
• palpitations
• paleness
• frequent or prolonged infections
• unexplained or easy bruising etc.

Adequate Platelets count play an important role in blood clotting and low count produces symptoms like delay in blood clotting, nose bleeds, bleeding gums and heavy menstrual bleeding in women.

In cases of severe anemia, the symptoms may involve rapid heart rate, low blood pressure, change in stool color, pale or cold skin, jaundice, heart murmurs, enlargement of the spleen etc.

Aplastic Anemia in Children

Aplastic anemia is a disorder that is caused when the human body’s bone marrow does not produce enough red blood cells necessary for oxygen supply to all parts of the body. Generally this disorder is found among children and young adults but adults may also be affected by Aplastic anemia.

Studies have shown that Aplastic anemia in children has many causes; some causes are idiopathic, that means they occur sporadically for no known reason where as other causes may be due to infections, illnesses, diseases or previous disorders. Studies report that a large number of cases (nearly 50%-75%) of Aplastic anemia in children are caused sporadically and occur for no known reason. In cases where the disorder is acquired factors include

• Exposure to radiation or toxic materials such as heavy metals
• Autoimmune diseases such as lupus
• Previous history of acquired conditions such as HIV, hepatitis, Epstein-Barr virus etc
• In some cases children may also inherit certain disorders (Fanconi anemia, amegakaryocytic thrombocytopenia, reticular dysgenesis, dyskeratosis congenital, familial Aplastic anemia, Shwachman-Diamond syndrome etc) which make them susceptible to Aplastic anemia.

Aplastic anemia prognosis

Aplastic anemia is a serious illness and if left untreated can even prove fatal.  It can leave the patient utterly fatigued, and at higher risk of contacting infections and uncontrolled bleeding. Although, with correct and timely diagnosis and treatment the chances of recovery increase substantially.  In some cases where the patients are affected with mild Aplastic anemia the disorder may resolving itself. But the most common cause of concern is relapse of some previously controlled diseases.

Aplastic anemia can develop in any age, but it is more common in young adults.  Bone marrow transplants, (well matched) with regular follow up care, have been known to be successful in overcoming Aplastic anemia.  Immune suppression is another method used to treat Aplastic anemia for elderly patients who, due to frail health, are un able to undergo bone marrow transplant .

With science making huge strides in medicine research, many diseases previously considered fatal, such as Aplastic anemia, today have much better prognosis.

How can Aplastic anemia be prevented? 

• Avoid exposure to chemicals and toxic materials - Aplastic anemia can be prevented by avoiding environments that expose a person to certain chemicals thus decreasing chances of developing the condition. People working in chemical factories, especially benzene which is a widely used industrial chemical in various manufacturing and chemical plants, should follow proper safety guidelines and avoid inhaling benzene to prevent Aplastic anemia.
• Avoid chemically treated food products - Certain foods which are treated with insecticides have harmful chemicals which can increase the chances of developing Aplastic anemia and hence the consumer should avoid buying these chemically treated food products.
• Take necessary precautions when working with hazardous chemicals - People who are engaged in automobile painting jobs should wear face mask as fumes from these products can cause brain damage as well as bone marrow problems which ultimately lead to Aplastic anemia.
• Consult medical physicians while undergoing radiation or chemotherapy - Patients suffering from cancer should consult the doctor about the risk of Aplastic anemia as these people are at a higher risk of developing this disease due heavy radiations treatments and chemotherapy which are used to kill deadly cancer cells.
• Eat healthy (iron rich foods) and exercise regularly - A healthy diet as well as regular exercise goes a long way in keeping a person healthy. In addition consumption of nutritious foods also boosts the overall immunity of the body helping keep Aplastic anemia as well as other ailments at bay.

Aplastic anemia can be best avoided by eating a wide variety of healthy foods which are rich in iron content. Fruits such as apples, bananas, apricots and plums; vegetables such as yams, squash, asparagus, broccoli and leafy vegetables, tofu, whole grains etc. all help in building the body’s resistance against Aplastic anemia.

To avoid Aplastic anemia, iron absorption in the body is vital. Iron rich foods, high in vitamin C, should be included in the regular diet. Sugar consumption should be reduced considerably or even omitted. Avoid using any antacids as they interfere with iron absorption. Coffee and black tea contain should also be avoided as they contain polyphenols and tannin which interfere with iron absorption.