Nowadays, there are a large number of a wide variety of diseases that are directly related to blood. One of these is aplastic anemia. Symptoms of this ailment do not occur immediately. Can this disease be cured? What preventative measures exist? This is 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 quite rare. Both men and the fair sex can get sick, more often after 50 years. In the absence of timely treatment, aplastic anemia often leads to death.
The mechanism of the development of the disease
As you know, hematopoiesis is carried out through a special group of cells, namely hematopoietic stem cells. They have the ability to multiply and differentiate into a variety of sprouts of hematopoiesis. It is from the latter that mature cells are formed (red blood cells, white blood cells, platelets, and others). Under the influence of a number of external or internal factors, the following mechanisms of the sequential development of the disease are possible:
- the number of hematopoietic stem cells gradually decreases;
- the primary function of stem cells is disrupted, which entails the impossibility of the formation of red blood cells, platelets and white blood cells;
The defeat of the stem cell in this case is confirmed by the effectiveness of bone marrow transplantation from identical twins or brothers / sisters. This is how aplastic anemia is treated in children and adults. However, transplantation is ineffective from the identical twin in the event that the recipient has not previously received a course of drugs to suppress immunity. This fact most often confirms the immune nature of the disease.
Main reasons
Unfortunately, the etiological factors for the development of the disease are not completely known. Experts believe that these may be:
- regular contact with certain groups of chemicals;
- alcohol abuse;
- genetic predisposition;
- ionizing radiation;
- intoxication of the body with drugs;
- some infectious diseases;
If specialists cannot establish a direct connection with the causes indicated above, the disease is called idiopathic aplastic anemia.
Symptoms
- Pallor of the skin, bruising.
- Dyspnea.
- Fever.
- Weakness, fatigue, dizziness.
- Tachycardia.
- Ulcerative stomatitis.
- Nasal or gingival bleeding.
- Decreased appetite, sudden weight loss.
These are far from all clinical signs of how aplastic anemia can manifest. Symptoms certainly vary in each case. Moreover, they often resemble other diseases of the hematopoietic system. That is why it is so important to seek medical help in a timely manner and pass all the necessary tests. There are certain blood standards for each gender and age. If, for example, biochemistry indicators are slightly different, the doctor will already prescribe a more detailed examination, and then the appropriate treatment.
Forms
Specialists conditionally classify this disease by origin into two types:
1. Congenital aplastic anemia is:
- hereditary (hematopoiesis and congenital malformations) Fanconi anemia;
- hereditary (hematopoiesis lesion without congenital malformations) Estren-Dameshek anemia;
- partial red cell aplasia (decrease in the number of red blood cells);
2. Acquired aplastic anemia are:
- with a general lesion of hematopoiesis;
- with selective lesion of erythropoiesis;
In addition, the disease is classified by severity:
- Mild aplastic anemia. A blood test shows high rates of some components, but this is not enough compared to the norm.
- Severe aplastic anemia. Underestimated platelet count, riticulocytes and granulocytes.
How is posthemorrhagic anemia different?
This is a fairly common type of anemia that occurs due to 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 an ordinary adult, a danger occurs if blood loss exceeds a volume of 500 ml.
This pathology, as a rule, occurs with an ectopic pregnancy, blood or liver diseases, severe blood loss after an injury or surgery.
It is noteworthy that the patient may not suspect the presence of this problem for several days. Pronounced symptoms appear 2-3 days after blood loss. If qualified help is not provided to the patient, the probability of death is very high.
A problem such as posthemorrhagic anemia is treatable. The doctor must first eliminate the main source of blood loss and transfusion of colloidal solutions.
Diagnostics
Most often, a suspicion of this disease arises after the next delivery of tests for preventive purposes. With anemia in the blood, the content of red blood cells, white blood cells 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 certain components may vary in each individual case.
To confirm the disease, aplastic anemia, a blood test is not the only diagnostic method. The doctor, as a rule, prescribes a more detailed examination of the patient, which includes:
- physical examination (determination of the color of the skin, blood pressure, the 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 an infectious nature);
- biochemical blood test (cholesterol, glucose, uric acid);
- complete history (if there are bad habits, are there any chronic diseases, was there contact with toxic substances);
- blood analysis;
- bone marrow examination by puncture;
- electrocardiography;
What should be the treatment?
First of all, it should be noted that only a qualified approach is able to help the patient in the fight against a disease such as aplastic anemia. The symptoms of this ailment in the early stages should alert everyone. Moreover, when primary clinical signs appear, it is important to immediately seek medical help for a detailed examination.
Modern medicine offers three treatment options. Below we consider each in more detail.
- Etiotropic treatment is recommended if the cause of anemia is known. In this situation, the main goal of therapy is to directly influence the provoking factor, but it is most often ineffective. It is recommended that patients exclude the main cause of the disease (removal of the radiation zone, cancellation of certain medications, etc.). Such measures only reduce the death rate of the bone marrow itself, but do not restore blood norms.
- Pathogenic treatment implies the elimination of the mechanisms of the development of the disease. For these purposes, immunosuppressive therapy is used (Cyclophosphamide, Cyclosporin preparations). In some cases, the use of these drugs can fully restore the function of hematopoiesis. Corticosteroids and anabolic steroids are also used in the treatment. These medications not only stimulate the formation of white blood cells, but also enhance protein synthesis. In severe cases of the disease, doctors recommend bone marrow transplantation. The effectiveness of the operation is much higher in young patients. Aplastic anemia in children is also treated through transplantation.
- Symptomatic therapy is used to combat specific manifestations of the disease. It includes transfusion of the main components of blood, antibacterial (medicines "Fluconazole", "Norfloxacin") and systemic antifungal therapy.
Complications and consequences
- Anemic coma. Due to the rapid decrease in red blood cells in the blood, almost no oxygen enters the brain, as a result, a person loses consciousness and does not respond to external stimuli.
- Infections
- Hemorrhagic complications (bleeding). The most terrible problem is the so-called hemorrhagic stroke, when part of the brain dies due to soaking it with blood.
- Deterioration of the condition of some internal organs (most often occurs in the presence of chronic diseases).
As already noted somewhat above, exclusively qualified treatment helps to overcome such a pathology as aplastic anemia. The prognosis is most often favorable, but only with timely medical attention. According to available statistics, about 90% of patients die within one year without appropriate therapy.
The most effective treatment method is bone marrow transplantation. So, 9 out of 10 patients after surgery live more than five years.
If surgical intervention is not possible (exclusively medical therapy), more than five years can live only half of the patients, and up to 40 years.
Prevention
Primary prevention involves actions to prevent the negative effects of various external factors on the body. Here we are talking about observing basic safety precautions when interacting with sources of ionizing radiation, dyes. In addition, it is important to control the administration of drugs and their dosage.
Secondary prophylaxis (prevention of worsening of the condition of an already sick person) implies follow-up observation, as well as long-term supportive treatment.
In conclusion, it should be noted that one should not be afraid of a diagnosis such as aplastic anemia. Photos of healthy people who have suffered this disease prove that it is possible to deal with the problem. In this case, a special role belongs to the timeliness of seeking qualified help and strict adherence to all recommendations from doctors. Be healthy!