16-24 Aplastic ANEMIA 16
Pancytopenia
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Myeloid stem cells farm
RBC
Platelets
All WBC except lymphocyte.
In Aplastic Anemia Either Myeloid
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Stem cells are
? Hypoproliferating ? destroyed
So all the products of this series
will go down:
RBC
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Platelets
All WBC except lymphocyte
(esp Granulocyte ? Granulocytopenia)
Pancytopenia ? ?ed RBC, WBC, Platelets
Causes:
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Count
? Aplastic Anemia
(This is misnomer this is actually
Aplastic www.FirstRanker.com
Mech how Myeloid SC becomes Hypoplastic 17
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? Myeloid S.C.
Environmental insult
Chemicals
Radiation
Viruses
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Mutant
Genetically
altered
M.S.C
Hypoplastic
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M.S.C
Class of
Proto-oncogene Function
Proliferation
Tumor Suppressor
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gene
(Gain of function)
Mutation
So there is ?ed Proliferation of gene
result will be pancytopenia.
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?ed formation of Myeloid cells.
?
Genetically
altered
S.C
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Causes:
Inherited
Altered pry
Surface
GPA
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THI
Neo-Antigen
IHQ
TINF? Myelo Suppression
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18
Inherited:
? Fanconis Synd:
@ Hypo poleforative MSc
? Defective DNA Repair Enzyme.
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(Hypoplasis)
@ defectino & spleen
Acquired:
? Idiopathic Cases 65%
Immunosuppression of M-S-C
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? che substances
? Bone (Thomb, Radius)
Dose related
Myelo supression
Predictable
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Reversible
Idio Syncratic way
Non predictable
Not Reversible
?
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fatal
alkylating agents
Anti mela balites
Benzene
Chloramphenical.
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Inorganic Arsenicals
Phenylbutazone
Streptomycin
Chloramphenical
Organic Arsenicals.
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? Physical agente.
Radiation
? Virus
Non A, Non B, Nore, Nong Hepatitis
eeg EBV , CMV www.FirstRanker.com
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19
All these factors can leads to Myelosuppress
So
RBC ? Anemia
WBC ? leukopenia
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Wed plate late ? Thrombocytopenia
Clinical Presention:
progressive Weakness
Anemia
Pallor
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Exertional dyspnea
fatigue
Thrombocytopenia < Pete chia
Ecchymosis
Leuko pen < Recurrant &
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frequent Infection.
Blood Picture.
?RBC
Normo Chromic Normocytic
Reticulo penia
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Bone Marrow Shindy
BM Aspiration
Many of B.M
is infilterate wilto
fat cells & there is
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Blood cell w
20
Treatment,
Young adults ? B.M. Transplantation.
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Elder > 50grs ? ATG Cantithymocyte Globin)
Cyclosporin
Supportive Rx
? PCV ? platelets ? WBC
Pure Red cell Aplasia:-
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Immune Mediated damage to
Erythroid precursor cells
but B.M is not Severely hypoplastic
Mainly these pt haro
Thymomas.
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Causes
Radiation Drag
Rx
Immuno Suppresion
BONE MARROW FAILURE &
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PANCYTOPENIA
Thymus
Anemia
Thrombocyto
Penia
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Leuko penia
21
Erythropoises / Derivatives of Myeloid
Thrombo poises S.Cells.
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Leuko poises
All of these functione one ?ed
in BM failure
Causes:
? Aplastic Anemia
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? Pure Red Cells Aplasia
? Space accopying lesion
? Metastasis Breast
Long
prostate
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? Sranulomatous diseases
T.B
? Myelo fibrosis
In which Megakaryocyte produce.
Out of growth factors (PDGF) ?ed.
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proliferaition of Myeloid cells ?
Myelo fibrosis
this cuill distrupt the Bone Structure
Severly ? Bone M fails
Spleen becomes source of
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Extra medullary Hemopoisis
Spleenomegaly
-RBC which comes ad of this fibrotic
cells will look like
Tear drop cells www.FirstRanker.com
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22
th is is known as Tear drop like.
Reticulocytosis
These can be seen by BM Biopsy.
? Myeloproliferative disorders.
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eq..
Leukemia Malagnancies of Hematopoietic
Precursor cells. so normal Hematopoietic
Sys is ?ed lol of Leukemic
cells Jump into blood leads to
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?ed Blood Count
Myelodysplasias- clonal stem cell disorders
Characterized by Maturation defect.
Any two of hematopoietic lines
will be Under Mature leads to
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Acute Myeloid Leukemia
Due to Space occupying lesions
Immature Precursor Cells may flood
to blood Normally Immature cells
from BM House does not Jump to
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Circulation this Condition is Called
? Leuco Erythro blastosis.
? Myelopthask Anemia: Panctopenia due to
-B.M destruction by Space creupyng
Jesions. www.FirstRanker.com
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23
B.M Suppression.
1) Liver diseases:
Toxic ?
Infection ?
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Cirrhosis ?
cytokines
In this
pancytopenia
Anemia is more Severe then
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lewkopenia < trombocytopenia
there is Usuallif
Macrocytic Anemia
b/c In Pheriptwal
takes Phospholipid leads to
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Cholestral
(MCU > 100 fL)
Circulation Sock RBC
Enlargment of
RBC Size.
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In liver diseases there are also bleeding
disorders ?
?Iron
there is also def of
Folic acid
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? Renal diseases
CRE
? ?ed Erythropoitin ? ?ed Erythropoises
? ? Memory www.FirstRanker.com
24
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Bleeding ? Iron deficiency.
Rx Erythropoitin
Iron
Pancytopenia: ?ed
WBC
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Platelets
In Circulation
Causes
? Bone M. disorders.
? Aplastic Anemia
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? Myelofibrosis
? Myelodysplasia
? Acute leukemias
? Megaloblastic Anemia ( due to ?ed
Folic acid & Vit B12)
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? Infilterative disease,
TB
Metastasic.
Multiple Myeloma
Mainy CCD leukemic
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? Non Marrow disorders
O spleenomegaly
SLE Cautoclonal B cells are activated.
auto Ab ore forme against
? Infection ? AIDS
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leishmaniasis www.FirstRanker.com
This download link is referred from the post: MBBS Lecture Notes for all subjects (updated for 2021 syllabus) - All universities
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