Aplastic Anemia Pa Tho Physiology

Pathophysiology

Predisposing Factors:

Precipitating Factors: •

•

Damage to the microenvironment of the marrow

Altered bone marrow function

Reduced hematopoiesis

- fatigue - dizziness - shortness of breath - pale skin - bruising - oral thrush

Anemia

Leukopenia

APLASTIC ANEMIA

Thrombocytopenia

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If Treated: Medical management Blood transfusion • - Pack RBC - Plat Platel elet et conc concen entr trat atee Bone Marrow • Transplantation (BMT) Peripheral Blood Stem • Cell Transplantation (PBSCT) Immunosuppressive Therapy Antithymocyte Globulin • Cyclosporine • Supportive theraphy • •

IVF Therapy Drug Theraphy

If Not Treated: Pancytopenia relapse

RBC Hypoxemia Hypoxia

platelet

WBC

hemorrhage

localized infection

hypovolemic Shock 

systemic infection

Anoxia

septic shock  DEATH

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Written Pathophysiology

Aplastic anemia is a rare disease that can either be congenital or acquired, but most cases are idiopathic or no apparent cause. This is caused by a decrease in or damage to marrow stem cells, damage to the microenvironment within the marrow and replacement of  the marrow with fat. Some factors that can trigger it are exposure to chemicals and radiation (benzene, pesticides) and infection. It results in bone marrow failure, which eventually alters the normal functioning of the bone marrow, which is to produce Red Blood Cells. As a result, there will be decreased production of red blood cells, which most probably lead to anemia (decreased RBC count), leukopenia (less than normal amount of WBC in the circulation) and thro thromb mbocy ocyto topen penia ia (dec (decre reas ased ed plat platel elet et count count). ). If this this condi conditi tion on will will not not be trea treate ted, d,  pancytopenia then relapses. As an effect, presence of abnormal decrease in RBC will lead anoxi anoxia. a. Plat Platel elet et will will also also decre decreas asee whic which h coul could d possi possibly bly lead lead to hemo hemorr rrha hage ge then then to hypovolemic shock. Moreover, there is also abnormal decrease in WBC which in return can lead to localized infection then to systemic infection after sometime that it is not treated, will   progress to septic shock that eventually lead to death. Since there is impairment in the  production of RBCs, WBCs and platelet, aplastic anemia can be manage through blood transfusions and can be treated through Bone Marrow Transplantation (BMT) and Peripheral Blood Stem Cell Transplantation (PBSCT). In others the disease can be managed with immunosuppressive therapy; a combination of Antithymocyte Globulin and Cyclosporine is most commonly used. Supportive therapy plays an important role in the management of  aplastic anemia. The patient pa tient is supported with transfusions of RBC and platelet p latelet as necessary. necessary.