What tests should be done to diagnose aplastic anemia?

Written by Zhang Xiao Le
Hematology
Updated on November 12, 2024
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The diagnostic criteria for aplastic anemia include a decrease in all blood cells, generally no enlargement of the liver or spleen, reduced or severe reduction in bone marrow hyperplasia in multiple sites, and exclusion of other diseases causing a decrease in all blood cells. Therefore, the diagnosis of aplastic anemia requires the following tests: complete blood count, reticulocyte count, abdominal ultrasound, bone marrow cytology, bone marrow chromosome analysis, bone marrow biopsy, rheumatoid immune indicators, and peripheral blood T-cell subgroups. Additionally, for patients suspected of having aplastic anemia, further flow cytometry and differentiation from myelodysplastic syndromes are sometimes necessary.

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Written by Li Fang Fang
Hematology
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The main cause of aplastic anemia is.

The causes of aplastic anemia are considered to be of three types: abnormalities in hematopoietic stem cells, abnormalities in the bone marrow microenvironment, and abnormalities in immune factors. Among these, abnormalities in immune factors play a dominant role. Therefore, most patients with aplastic anemia see some improvement after receiving immunosuppressive therapy clinically. However, there is a small subset of patients with aplastic anemia for whom immunosuppressive therapy is not effective, and the causes of the disease in these patients are not well understood and may be congenital, such as congenital dyskeratosis.

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Written by Li Fang Fang
Hematology
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Aplastic anemia is classified into several types.

Aplastic anemia is divided into two types: acute aplastic anemia and chronic aplastic anemia. Acute aplastic anemia presents suddenly and is severe. Treatment requires intensified immunotherapy or suppression of hematopoietic stem cell transplantation. Chronic aplastic anemia develops slowly, has a longer history, and is relatively less severe. The treatment for chronic aplastic anemia mainly involves immunotherapy combined with therapy to promote hematopoiesis. In addition, regardless of the type, all cases of aplastic anemia require regular complete blood count checks and, when necessary, supportive treatment with red blood cell and platelet transfusions.

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Written by Li Fang Fang
Hematology
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Does aplastic anemia cause fever?

Aplastic anemia itself does not cause fever in patients; however, individuals with aplastic anemia experience a decrease in all blood cells, including white blood cells, red blood cells, and platelets. A significant reduction in white blood cells, such as in a state of neutropenia, can lower a patient's resistance to infections, which makes it easy for secondary infections to occur and thus induce fever. Furthermore, in cases of severe anemia, severe aplastic anemia can also lead to the occurrence of low-grade fever in patients. On the other hand, a reduction in platelets generally does not cause fever. Therefore, when a patient with aplastic anemia has a fever, it is important to determine the cause of the fever.

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Written by Zhang Xiao Le
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Does aplastic anemia easily cause oral ulcers?

Patients with aplastic anemia are more prone to oral ulcers. Aplastic anemia is a type of bone marrow failure syndrome, where there is a decrease in white blood cells, red blood cells, and platelets in the peripheral blood to various extents. Long-term anemia can lead to mucosal ischemia and hypoxia. The reduction in white blood cells weakens the mucosal barrier's protective function, making it susceptible to bacterial invasion and thus prone to oral ulcers. Additionally, patients with anemia often have poor diets over long periods, leading to a deficiency in various vitamins, which is another reason why they are prone to oral ulcers. If symptoms like joint pain are present along with oral ulcers, further rheumatological and immunological tests should be conducted to rule out rheumatic and immune system diseases.

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Written by Zhang Xiao Le
Hematology
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The differences between aplastic anemia and megaloblastic anemia.

Aplastic anemia is a type of bone marrow failure syndrome where patients can present with reduced total blood cells in the peripheral blood, without enlargement of the liver, spleen, or lymph nodes, and an increased ratio of peripheral blood lymphocytes. Bone marrow indicates low regeneration, reduced hematopoietic tissue, and increased non-hematopoietic tissue, with the condition arising from changes in the bone marrow microenvironment leading to a reduction in blood cells. Megaloblastic anemia, also known as nutritional anemia, is primarily caused by a lack of folate and vitamin B12, leading to a red blood cell synthesis disorder and resulting in anemia. Severe megaloblastic anemia can also present with reduced total blood cells. However, the red blood cells typically exhibit macrocytic anemia. In contrast, aplastic anemia generally presents with normocytic anemia.