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Aplastic anaemia is a rare and potentially very serious condition that is the consequence of a reduction in the blood forming cells in the bone marrow. People with aplastic anaemia have low haemoglobin (anaemia), low white blood cells (immune system cells which fight infection) and low platelets (small cells which stop bruising & bleeding).
Aplastic anaemia is classified into three main types:
Acquired aplastic anaemia: This is the most common type and develops after birth. It can be caused by factors such as exposure to radiation, chemotherapy, toxins, certain medications or viral infections.
Inherited aplastic anaemia: Also known as congenital aplastic anaemia, this type is present at birth and results from genetic mutations. The most common form is Fanconi anaemia.
Idiopathic aplastic anaemia: In this type, the cause is unknown. It is diagnosed when no specific underlying factor can be identified.
People with aplastic anaemia may look pale, feel more tired than usual and get breathless easily. As their white blood cells are low, they will be prone to severe infections and a low platelet count will increase the risk of bruising and bleeding.
There is no effective prevention for most cases of aplastic anaemia.
Some chemicals and toxins, such as herbicides and organic solvents, can predispose certain individuals to developing aplastic anaemia. Reducing exposure to these substances may help lower this risk. When exposure to such chemical cannot be avoided, safe handling practices should be employed.
Most aplastic anaemia cases are due to suppression of the bone marrow by the immune system.
Viral infections: Certain viruses, such as hepatitis, Epstein-Barr virus and HIV, can lead to aplastic anaemia by damaging the bone marrow.
Radiation and chemotherapy: Treatment for cancer and other conditions can harm the bone marrow, potentially leading to aplastic anaemia.
Autoimmune conditions: People with autoimmune disorders like lupus may be at higher risk due to immune system dysregulation.
Exposure to industrial chemicals: Contact with chemicals like benzene or pesticides can increase the risk of developing aplastic anaemia.
A diagnosis of aplastic anaemia may be suspected from the history, physical examination and routine blood tests. A bone marrow biopsy is required to confirm the diagnosis of aplastic anaemia and further investigations are usually carried out to try to determine a cause.
Patients with mild aplastic anaemia and have no symptoms will be managed with close observation.