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BONE MARROW DISORDERS, APLASTIC ANAEMIA, Severe aplastic anaemia - Coggle…

- - - - Fanconi's anemia
        
        congenital
      - immunologically- mediated
        
        acquired
      - secoundary aplastic anemia
        
        1.DRUGS
        
        table
        
        2.toxic chemicals
        
        eg: insecticides
        
        3.infections
        
        eg:
        infectious hept
        EB virus infection
        AIDS
        other viral illnesses
        
        4.miscellaneous
        
        eg: theraputic X-rays
  - - - mild progressive weakness and fatigue
      - Haemorrhage from various sites due to thrombocytopenia
        
        Infections of the mouth and throat
        
        Lymph nodes, liver and spleen
        not enlarged
    - - Anaemia
        
        Hb levels moderately reduced
        
        Blood film
        
        normocytic normochromic anaemia. Reticulocyte count is reduced or zero
        
        Leucopenia
        
        absolute granulocyte count is particularly low, relative lymphocytosis
        
        Thrombocytopenia
        
        abnormally low levels of platelets
        
        always reduced
        
        Bone marrow
        
        may yield dry tap.
        
        Trephine biopsy reveals patchy cellular areas,
        
        hypocellular or aplastic marrow, replacement by fat.
        
        Severe depression of myeloid cells, megakaryocytes and erythroid cells.
        
        HSC with CD34 marker are markedly reduced or absent
        
        low white blood cell count (leukopenia) is a decrease in disease-fighting cells (leukocytes) in your blood. Leukopenia is almost always related to a decrease in a certain type of white blood cell (neutrophil)
      - PRINCIPLES OF TREATMENT
        
        General management
        
        identification and elimination of possible cause,
        
        supportive care
        (blood transfusions, platelet concentrates,
        prevention of infections)
        
        Specific treatment
        
        Marrow stimulating therapy
        
        androgen orally
        
        Immunosuppressive therapy
        
        antithymocyte globulin and anti-lymphocyte serum,
        
        very high doses of corticosteroid or cyclosporine
        
        Bone marrow transplantation
        
        considered in severe cases under age of 40.