A short case study on a patient with aplastic anaemia !! easy to understand !

3. General Information of Disease
Aplastic anemia is a condition that occurs when your body stops
producing enough new blood cells. The condition leaves you
fatigued and more prone to infections and uncontrolled bleeding.
A rare and serious condition, aplastic anemia can develop at any
age. It can occur suddenly, or it can come on slowly and worsen
over time. It can be mild or severe.
There are two types of aplastic anemia:
• Inherited aplastic anemia occurs because of a random gene
mutation. It is most common in children and younger adults.
• Acquired aplastic anemia occurs because of an immune system
problem. It is most common in older adults, but can occur in
younger adults.

4. CASE STUDY
A mother came to the outpatient department with
her son, Imran Khan aged 11 years who was
experiencing a 3 week old history of petechial rash
and intermittent epistaxis. He has coughing for at
least a week, has experienced rhinorrhea, and has
been fussier than normal in his day to day life. His
appetite is also reduced significantly since few
days, hence the fatigue. Previously the patient had
visited a local clinic upon which he was prescribed
amoxicillin and acetaminophen respectively. Travel
history : A field trip to a industry and a farm
subsequently 4 weeks ago.

5. On physical examination, the patient, Imran Khan had an oral temperature
of 37.6°C and the oxygen saturation was 96% on room air , pulse = 80/min
He was slightly underweight( probably due to the poor appetite since few
days ) young boy and presented with cough and nose running. Pale skin was
also observed
Scattered petechial rashes noted on the patient's trunk and extremities,
as well as a few ecchymoses on his bilateral lower extremities.
Rhythmic heart sounds on auscultation
Impalpable liver and spleen ; diuresis present
No evidence of meningeal irritation signs.
PHYSICAL EXAMINATION

6. LAB DIAGNOSTICS

7. LAB DIAGNOSTICS
• Laboratory investigations revealed:
• Pancytopenia (Pancytopenia is a condition in which a person’s
body has too few red blood cells, white blood cells, and
platelets.)
• Biological inflammatory syndrome (ESR = 70 mm/h, CRP = 2.37
mg)
• Mean Corpuscular Volume 88.7 fL ( Its normocytic because 80-
100 comes under this range )
Bone marrow puncture was performed to confirm the diagnosis,
which revealed a bone with low cellularity, apparently without
morphological modifcations, confirmed by the biopsy which
revealed a bone marrow with low cellularity.

8. FINAL DIAGNOSIS
By correlating clinical and laboratory data the final
diagnosis of APLASTIC ANAEMIA was done.
Factors supporting the final diagnosis were :
a) anamnesis
b) morphological abnormalities (looking pale, Scattered
petechial rashes noted on the patient's trunk and
extremities, as well as a few ecchymoses on his
bilateral lower extremities )
c) Hematology (pancytopenia, bone marrow with low
cellularity).

9. • Acute Lymphoblastic Leukemia (ALL)
• Acute Myeloid Leukemia (AML)
• Megaloblastic Anemia
• Multiple Myeloma
• Non-Hodgkin Lymphoma (NHL)
• Paroxysmal Nocturnal Hemoglobinuria
DIFFERENTIAL DIAGNOSIS

10. TREATMENT
• Blood Transfusion is to be done
• Antibiotic Therapy ( cephalo (Ceftriaxone 1 g × 2)
• Corticosteroids (Prednison 5 mg/kg/day ) IV
• Immunosuppressants if the cause of the disease is actually
autoimmune.
• Anti Lymphocytic globulin 40mg/kg/day
• Acetaminophen if fever arises
• In adverse cases Bone marrow transplant can also be
done/
• Diet control

11. PROPHYLAXIS
• There's no prevention for most cases
of aplastic anemia. Avoiding
exposure to insecticides, herbicides,
organic solvents, paint removers
and other toxic chemicals might
lower your risk of the disease