Ljubav na djelu

2014-08-21

Aplastic anemia:
Aplastic anemia occurs because of the inability to get in the bone marrow produce all types of blood cells. It differs from leukemia in that the defect arises because the cells do not divide, rather than not ripen. As a result, the bone marrow contains a large amount of fat cells, rather than to the formation of blood cells, which normally would have been present. It can occur in people of any age, but usually occurs in people between 15 and 24 years, and over 60 years. The disease may initially resemble leukemia.

Is considered to be caused by damage to the common stem cells from which all later develop of blood cells. The result is a low level of development or underdevelopment of the bone marrow.

· Congenital causes: Aplastic anemia occurs in Fanconi anemia and congenital diskeratoses

· Immune causes: treatment with drugs that suppress the immune system (immunosuppressants) after bone marrow transplantation procedures can cause aplastic anemia.

· Drugs and Poisons: aplastic anemia is common after treatment with drugs that suppress the immune system (immunosuppressants), anti-tumor drugs (cytostatics, chemotherapy), after radiation, taking the derivatives of benzene and other hydrocarbons, chloramphenicol, etc.

Start of aplastic anemia in the majority of patients indistinguishable. The first symptoms are weakness and fatigue which causes a decreased number of red blood cells (RBCs). The lack of red blood cells caused by reduced production in the bone marrow and bleeding from the nose, gums, vagina, digestive system, subcutaneous tissues. The majority of the patients bleeding milder, in some as the first symptom occurs bleeding in the retina of the eye or brain. Bleeding occurring due to lack of blood platelets - platelets. Patients usually have a very low number of white blood cells that are used by the immune system, but it is interesting that they have so often bacterial infections. Patients are very pale, and the skin, eye conjunctiva, eye background and gums can be located dotted bruises and bleeding (hematoma). Fever is common, and typical signs of infection are often absent due to the extremely low number of leukocytes (white blood cells).

The diagnosis of aplastic anemia is based on:

· Blood tests while watching the number of cells
· Bone marrow puncture
· Bone biopsy
· Concentration of iron and its carrier (transferrin) in the blood

All these tests show a reduction of all types of blood cells.

Prognosis depends largely on the severity of the disease, the less the cause. A milder form can switch to a more severe form, in some patients, the production of one or more branches of blood cells can completely normalize.  In the course of infections and diseases affecting  the type and location of the bleeding.  Although infections are the primary symptom of the disease,  eventually becoming one of the most important factors for the disease course. The lack of red blood cells and platelets are often treated with blood transfusions, which is associated with various complications such as inflammation of the liver (hepatitis) and deposition of iron in the body (hemosiderosis).  In these patients at increased risk of developing leukemia, mielodisplastic syndrome or paroxysmal nocturnal hemanoglobin.

Mild forms are treated with androgens (male sex hormones), a severe form of bone marrow transplant. In the majority of patients after bone marrow transplantation showed a recovery hematopoietic system.
Supportive measures are important in all cases of the disease, and involve the removal of harmful environmental factors of patients, the treatment of infections with antibiotics and steroid administration in female contraceptives (anti-baby pill) to prevent excessive menstrual bleeding. Apply even transfusions, factors that stimulate the bone marrow cells and drugs that suppress the immune system.

The treatment is performed by immunosuppressive drugs, stem cell transplantation, means for stimulating growth and blood (anabolic) hormones to build tissue.