Question

Case Study Ab20-year-old woman was seen by her physician for fatigue, pallor, and easy bruising. Physical examination was unremarkable except for pallor, widespread petechiae, ecchymosis, and bleeding gums. The spleen was not enlarged. There was no history of recent exposure to drugs, toxins, or radiation. There was no history of any other illness, and she had been in good health until the past 2 weeks. Laboratory data revealed a normochromic, normocytic anemia with a hematocrit of 20%, WBC of 20 X 106/ul, and platelets of 20 x 106/uL. Case Study The peripheral blood showed 9% neutrophils, 90% lymphocytes, and 1% monocytes. A bone marrow aspirate and biopsy specimen was markedly hypocellular, with less than 5% cellularity composed of lymphocytes and plasma cells admixed with a rare myeloid or erythroid precursor. No megakaryocytes were noted. No dysplastic changes were noted in the few hematopoietic cells seen, and there was no increase in the number of blasts. Further studies failed to identify an underlying etiology for the patient's pancytopenia.

Answer 1

1. Aplastic anemia

reason for predicting the diagnosis are the following:

• Aplastic anemia causes pancytopenia.
• It is seen mostly in teens and also at their twenties.
• Diagnosis is usually done by bone marrow biopsy and the result will be low stem cells,replaced by fat.
• Signs and symptoms include pale skin,bleeding,bruising and petechiae.
• Treatment is bone marrow transplant with an HLA matched sibling donor.

2.Possible Etiologies

• Radiation and chemotherapy treatments
• Autoimmune disorder
• Toxins such as pesticides
• Pregnancy-after giving birth, aplastic anemia can develop by its own in the mother.
• Drugs taken to treat other conditions like rheumatoid arthritis
• Infectious diseases such as hepatitis.

3.Clinical approach to therapy

Stem cell transplantation is the treatment of choice for young patients if they have a HLA matched sibling donor.