ALASTIC ANAEMIA IN THIS TYPE BONE MARROW UNABLE TO PRODUCE ENOUGH BLOOD IN BODY.

1. SEMINAR
ON
TOPIC – APLASTIC ANEMIA IN
CHILDREN
SUBJECT - CHILD HEALTH NURSING
BY,
MR. ABHIJIT P. BHOYAR
M. SC. NURSING
CHILD HEALTH NURSING

2. APLASTIC ANAEMIA
• INTRODUCTION
• Aplastic anemia is a serious condition in which the
bone marrow does not produce enough new blood
cells.
• It may be passed down from the parents or develop
sometime during childhood.
Aplastic anaemia (AA) is a rare condition in which the bone marrow
fails to produce all three major types of blood cell. It is not a form of
cancer.

3. • Aplastic anemia is a type of anemia caused by
problems with bone marrow. It can range
from mild to severe.

4. CAUSES
• Unknown etiology
• Stem cell defect: intrinsic defects of
hematopoietic stem cells
• Bone marrow defects
• Abnormal hematopoiesis related
to humoral or cellular immune
function
• Adverse effects of certain drugs

5. CAUSES
• Exposure to certain chemicals and pathogens, such as contaminated
water, animal fertilizer, and pesticides
• Inherited conditions: mutations such as those present in the Shwachman-
Bodian-Diamond syndrome (SBDS) gene (occurs from biallelic mutations)
• Infections that cause autoimmune pathogenesis: immune mediated
hematopoietic cell destruction from conditions such as fulminant liver
failure (FLF), which occurs secondary to some forms of hepatitis,
echovirus, parvovirus, metabolic veno-occlusive disease and other
pathologies

6. RISK FACTORS
•Exposure to certain environmental toxins
•High dose radiation and chemotherapy
treatments
•Certain viruses
•Certain medications
•Bone marrow diseases
•Pregnancy

7. PAHOPHYSIOLOGY

8. Types of aplastic anaemia
There are several types of aplastic anaemia:
• Acquired aplastic anaemia – this is the most common type
where there is often no obvious or known cause.
• Inherited bone marrow failure syndromes – there are rare
inherited conditions which may lead patients on to develop
aplastic anaemia. The most common of these is Fanconi
anaemia.

9. The classification is based on how low the numbers of blood cells have fallen, which can be
found out by a blood count.
• To make a diagnosis of AA, at least two of the following must be present:
• Haemoglobin less than 100g/L
• Platelet count less than 50 x 109/L
• Neutrophil count less than 1.5 x 109/L
• AA is classified as non-severe, severe or very severe.
• Non-severe aplastic anaemia
• This meets the above criteria for aplastic anaemia but does not meet the criteria for severe
or very severe aplastic anaemia.
• Severe aplastic anaemia
• Hypocellular bone marrow and any two of the following:
• A low platelet count (less than 20 x 109/L)
• A reticulocyte count less than 20 or 60 x 109/L
• A neutrophil count less than 0.5 x 109/L
• Very severe aplastic anaemia
• Hypocellular bone marrow and any two of the following:
• A low platelet count (less than 20 x 109/L)
• A reticulocyte count less than 20 or 60 x 109/L
• A neutrophil count less than 0.2 x 109/L
• The difference between severe and very severe AA is how low the number of neutrophils
falls; which increases the risk of severe infection.
• Hypocellular bone marrow is defined as bone marrow cells <25%, or 25-50% with less than
30% of stem cells in your bone marrow.

10. CLINICAL MANIFESTATIONS
• Fatigue
• Shortness of breath with activity
• Weakness
• Rapid heart rate
• Pale skin
• Easy bruising
• Nosebleeds and bleeding gums
• Lengthy bleeding from cuts
• Skin rash
• Fever
• Shortened attention span

11. DIAGNOSTIC EVALUATION
• Medical history & physical
examination
• Blood tests

12. • Bone marrow examination
• Chromosomal studies
• Testing for immunological etiologies
• Testing for Shwachman-Bodian-Diamond syndrome

13. • HLA-typed testing
microarray analysis

14. MANAGEMENTBlood Transfusions Bone Marrow Transplantation
Immune Suppressing Medication
Androgen therapy
Antibiotics therapy

15. • Erythropoietin
treatment and
pancreatic enzymes
• Close monitoring
• Bed rest

16. NURSING MANAGEMENT
• Frequent assessment
• Monitoring for adverse effects
• Assessment of coping abilities
• Provide emotional support
• Patient and family teaching

17. COMPLICATION
Complications may include:
• Severe infections or bleeding
• Complications of bone marrow transplant
• Reactions to medicines
• Hemochromatosis (buildup of too much iron in the
body tissues from many red cell transfusions)

18. PREVENTION
• Limiting exposure to certain environmental toxins
• Environmental toxins include those found in
gasoline, paint, oil and coal emissions, and
industrial solvents.

20. references