Aplastic anemia: Difference between revisions
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'''Aplastic anemia''' is clinical syndrome, characterized by a hypoplastic [[bone marrow]] in the setting of [[pancytopenia]]. The pathogenesis of aplastic anemia is damage to the [[pluripotent stem cell]] reserves of the [[bone marrow]], which leads to profound low [[white blood cell]], [[red blood cell]], and [[platelet]] counts. | '''Aplastic anemia''' is clinical syndrome, characterized by a hypoplastic [[bone marrow]] in the setting of [[pancytopenia]]. The pathogenesis of aplastic anemia is damage to the [[pluripotent stem cell]] reserves of the [[bone marrow]], which leads to profound low [[white blood cell]], [[red blood cell]], and [[platelet]] counts. | ||
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[[Fanconi's anemia]] is the most common hereditary aplastic anemia. Genes involved in [[DNA mismatch repair]] have been implicated in [[Fanconi's anemia]], and aplastic anemia usually takes place before adulthood. | [[Fanconi's anemia]] is the most common hereditary aplastic anemia. Genes involved in [[DNA mismatch repair]] have been implicated in [[Fanconi's anemia]], and aplastic anemia usually takes place before adulthood. | ||
==Drugs and aplastic anemia== | ==Drugs and aplastic anemia== | ||
Clinicians will avoid drugs associated with aplastic anemia unless there is no better alternative, which is indeed the case. Not all drugs carry the same risk, and thus are more likely to be used. Some of these include: | |||
*Phenylbutazone | *[[Phenylbutazone]] | ||
*Chloramphenicol | *[[Chloramphenicol]] | ||
*Gold | *[[Gold]] | ||
* | *[[Sulfonamide]]s | ||
* | *[[Sulfonylurea]]s, such as glipizide | ||
*Felbamate | *[[Felbamate]] | ||
*Carbamazepine | *[[Carbamazepine]] | ||
*Valproic acid | *[[Valproic acid]] | ||
*Phenytoin | *[[Phenytoin]] | ||
*Nifedipine | *[[Nifedipine]] | ||
*Ticlopidine <ref>{{cite journal |author=Symeonidis A, Kouraklis-Symeonidis A, Seimeni U, Galani A, Giannakoulas N, Fragopanagou E, Tiniakou M, Matsouka P, Zoumbos N |title=Ticlopidine-induced aplastic anemia: two new case reports, review, and meta-analysis of 55 additional cases |journal=Am J Hematol |volume=71 |issue=1 |pages=24-32 |year=2002 |pmid=12221670}}</ref> | *[[Ticlopidine]] <ref>{{cite journal |author=Symeonidis A, Kouraklis-Symeonidis A, Seimeni U, Galani A, Giannakoulas N, Fragopanagou E, Tiniakou M, Matsouka P, Zoumbos N |title=Ticlopidine-induced aplastic anemia: two new case reports, review, and meta-analysis of 55 additional cases |journal=Am J Hematol |volume=71 |issue=1 |pages=24-32 |year=2002 |pmid=12221670}}</ref> | ||
*Clopidogrel <ref>{{cite journal |author=Meyer B, Staudinger T, Lechner K |title=Clopidogrel and aplastic anaemia |journal=Lancet |volume=357 |issue=9266 |pages=1446-7 |year=2001 |pmid=11360950}}</ref> | *[[Clopidogrel]] <ref>{{cite journal |author=Meyer B, Staudinger T, Lechner K |title=Clopidogrel and aplastic anaemia |journal=Lancet |volume=357 |issue=9266 |pages=1446-7 |year=2001 |pmid=11360950}}</ref> | ||
*Penicillin | *[[Penicillin]] | ||
*Allopurinol | *[[Allopurinol]] | ||
*Furosemide | *[[Furosemide]] | ||
==Radiation-induced aplastic anemia== | ==Radiation-induced aplastic anemia== | ||
[[Acute radiation syndrome]] with a single exposure to 5 Gy of radiation energy will kill 50 percent of recipients, due to irreversible injury to hematopoeitic stem cells. | |||
==Infection-induced aplastic anemia== | ==Infection-induced aplastic anemia== | ||
==Idiopathic aplastic anemia== | ==Idiopathic aplastic anemia== | ||
Revision as of 22:18, 10 June 2010
Aplastic anemia is clinical syndrome, characterized by a hypoplastic bone marrow in the setting of pancytopenia. The pathogenesis of aplastic anemia is damage to the pluripotent stem cell reserves of the bone marrow, which leads to profound low white blood cell, red blood cell, and platelet counts.
Patterns of aplastic anemia include:
- Hereditary
- Drug-induced
- Radiation
- Infection
- Idiopathic
Hereditary forms of aplastic anemia
Fanconi's anemia is the most common hereditary aplastic anemia. Genes involved in DNA mismatch repair have been implicated in Fanconi's anemia, and aplastic anemia usually takes place before adulthood.
Drugs and aplastic anemia
Clinicians will avoid drugs associated with aplastic anemia unless there is no better alternative, which is indeed the case. Not all drugs carry the same risk, and thus are more likely to be used. Some of these include:
- Phenylbutazone
- Chloramphenicol
- Gold
- Sulfonamides
- Sulfonylureas, such as glipizide
- Felbamate
- Carbamazepine
- Valproic acid
- Phenytoin
- Nifedipine
- Ticlopidine [1]
- Clopidogrel [2]
- Penicillin
- Allopurinol
- Furosemide
Radiation-induced aplastic anemia
Acute radiation syndrome with a single exposure to 5 Gy of radiation energy will kill 50 percent of recipients, due to irreversible injury to hematopoeitic stem cells.
Infection-induced aplastic anemia
Idiopathic aplastic anemia
Treatment
References
- ↑ Symeonidis A, Kouraklis-Symeonidis A, Seimeni U, Galani A, Giannakoulas N, Fragopanagou E, Tiniakou M, Matsouka P, Zoumbos N (2002). "Ticlopidine-induced aplastic anemia: two new case reports, review, and meta-analysis of 55 additional cases". Am J Hematol 71 (1): 24-32. PMID 12221670.
- ↑ Meyer B, Staudinger T, Lechner K (2001). "Clopidogrel and aplastic anaemia". Lancet 357 (9266): 1446-7. PMID 11360950.