Diagnosing Aplastic Anemia
bone marrow failure disease
There is no test known for Aplastic Anemia. Conversely, it is a diagnosis made by process of elimination, followed by confirmation with a bone marrow biopsy.
Aplastic Anemia is a bone marrow failure disease that causes the bone marrow to produce t-cells that in turn attack and kill bone marrow blood stem cells and replace blood stem cells in the marrow with deposits of fat. Slides prepared during a bone marrow biopsy will actually reveal the fat deposits to the naked eye, but must be observed under a microscope for confirmation.
Aplastic Anemia diagnostics may take several months, even years depending on the progression of the disease. Consequently, it can be easily misdiagnosed as doctors search for the cause of the declining blood levels.
The long road to aplastic anemia
B-12 assists the body in many ways; one of its primary purposes is to assist with the development of healthy red blood cells. Normally, if a person is B-12 deficient, an annual injection of B-12 will restore B-12 in their system and bring their B-12 mesurements up to normal or nearly normal levels.
Certain anemias can interfere with B-12 absorption, usually by prohibiting B-12 from being absorbed in the stomach from food. For example, low folic acid levels can cause the body to fail to absorb B-12.
While a B-12 deficiency is not indicative of Aplastic Anemia, it can serve to mask Aplastic Anemia by leading diagnostics down the wrong path. A B-12 deficiency can cause red blood cells to be enlarged; a lab test can determine if this is the case. MCV measures the size of a red blood cell. When a person is B-12 deficient, the MCV, which is normally no larger than 100, can be larger than normal (over 100).
The enlarged red blood cells are symptomatic of Aplastic Anemia. As the bone marrow becomes disfunctional, the body recognizes a need for greater quantities of red blood cells. The marrow responds by blasting immature red blood cells into the bloodstream. Those cells are incapable of performing the required red blood cell functions within the body, nevertheless they are produced and subsequently terminate and are disposed of by the liver. See also ITP below, which includes the complications of the spleen.
B-12 deficiencies are usually treated by restoring B-12 through pills or injections. If the person has a B-12 based anemia, those treatments may resolve the deficiency. If the person has Aplastic Anemia, those treatments will not resolve the underlying reduction in blood levels, nor the B-12 deficiency.
Indiopathic Thrombocytopenic Purpura - ITP
Initially, early symptoms for Aplastic Anemia can resemble symptoms of ITP, Indiopathic Thrombocytopnenic Purpura. ITP presents with easy bruising, bleeding from the gums or nose, blood in the urine or stools, heavy menstral flows, slow clotting times for wounds and later, Petechiae, tiny purplish red dots on the skin caused by bleeding under the skin.
Aplastic Anemia presents the same symptoms.
ITP is idopathic, which means, in short, of an unknown origin. Aplastic Anemia is often idiopathic, if not inherited or directly correlated to exposure to chemicals or drugs.
ITP forms antibodies that destroy blood platelets. Aplastic Anemia can present with the same symptom of low platelets.
ITP is treated with prednisone or gamma globulin to increase production of platelets. Both drugs may also be used in a frutile attempt to treat Aplastic Anemia. In both cases, stopping the gamma globulin or prednisone will result in decreased platelet levels, but for different reasons. Low platelets as a result of ITP are caused by the spleen, whereas low platelets as a result of Aplastic Anemia are caused by the bone marrow.
Lymphoma, Leukemia, MDS, PNH
Other diseases that present with simular symptoms to Aplastic Anemia are Lymphoma, Leukemia, MDS and PNH.