aplastic Anemia

Anemia is a condition where red blood cell count or the number homoglobin (oxygen-carrying protein) in red blood cells is below normal. Red blood cells contain homoglobin, allowing them to transport oxygen from the lungs and deliver it to all parts of the body. Anemia leads to reduced number of red blood cells or amount homoglobin in red blood cells, so that blood can not carry oxygen in the body as needed.

Aplastic anemia is anemia due to bone marrow aplasia in which hemopoiesis tissue is replaced by fat tissue, divided into two, namely:

A. Severe aplastic anemia
1. Bone marrow cells <25% and there are 2 of the 3 following symptoms

•  Granulocytes <500/uI
•   Platelets <20.000/uI
•   Reticulocytes <10% 0

2. plastic anemia

• The bone marrow is hypoplastic
• Pensitopenia with one of three blood tests such as severe aplastic anemia

DIAGNOSIS
• History:

1. History of exposure to toxic substances (drugs, workplace, hobbies), suffering from a viral infection last 6 months (hepatitis, parvovirus), had received a blood transfusion
2.   Symptoms of anemia: weakness / weakness, dizziness, shortness of breath / heart failure, dizzy
3.   Signs of infection: fever often
4.   As a result of thrombocytopenia: bleeding (menstrual length, epistaxis, bleeding gums, bleeding under the skin, hematuria, blood mixed bowel, vomiting of blood)

• Physical examination: conjunctival pallor, tachycardia, signs of bleeding
• Investigation: complete blood count was found pancytopenia, viral serology (hepatitis, parvovirus)
• Definitive diagnosis: bone marrow cytology and histopathology

DIAGNOSIS
Myelofibrosis, hemolytic anemia, deficiency anemia, anemia due to chronic disease, anemia due to disease of bone marrow malignancy, hypersplenism, acute leukemia
Examination support
• Laboratory: complete blood count, viral serology
• Aspiration and biopsy of bone marrow

TREATMENT
Adjunctive therapy:
• Transfusion of blood components (PRC and / or TC) as indicated (on the topic of blood transfusion)
• Avoid and cope with infection
• Corticosteroids: prednisone 1-2 mg / kg / day
• Androgens: Metenolol acetate 2-3 mg / kg / day. maximum is given for 3 months
• Splenectomy done when no response to steroids. If the patient refused splenectomy immunosuppressive therapy can be given:

• Cyclosporine 5 mg / kg / day
• ATG (anti-thymocyte globulin) 15mg/kgBB/hari intravenously for 5 days
• Bone marrow transplant, if found suitable HLA

COMPLICATIONS
Infection can be fatal, bleeding, heart failure in severe anemia