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

If Treated: Medical management • Blood transfusion - Pack RBC - Platelet concentrate • 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

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 thrombocytopenia (decreased platelet count). If this condition will not be treated, pancytopenia then relapses. As an effect, presence of abnormal decrease in RBC will lead anoxia. Platelet will also decrease which could possibly lead to hemorrhage 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 is supported with transfusions of RBC and platelet as necessary.