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General Practice 2023

Medullar aplasia: what é, symptoms, possible causes and treatment

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Medullar aplasia: what é, symptoms, possible causes and treatment
Medullar aplasia: what é, symptoms, possible causes and treatment

Medullar aplasia, also called bone marrow aplasia or aplastic anemia, is a disease characterized by an alteration in the functioning of the bone marrow, which results in low concentrations of red blood cells, platelets and leukocytes circulating in the blood, which it can lead to the appearance of some symptoms such as pallor, shortness of breath, bruising and frequent infections.

The cause of bone marrow aplasia is not generally known, but it may be associated with exposure to chemicals, radiation, medications, or be the result of a more serious illness such as Fanconi anemia.

Treatment is established according to the degree of aplasia and is usually done with the use of immunosuppressive drugs, antibiotics, blood transfusions and, in the most severe cases, bone marrow transplantation.Treatment can only be established by the physician after the result of the blood count and myelogram, which must be requested by the physician.

Symptoms of Medullary Aplasia

Because it is a disease in which there is a low number of red blood cells, platelets and leukocytes, the symptoms of medullary aplasia are related to the decrease of these elements in the blood:

  • Excessive fatigue;
  • Shortness of breath;
  • Pale;
  • Presence of purple spots on the skin;
  • Abnormal bleeding;
  • Frequent infections.

These symptoms may appear suddenly or more slowly and gradually. In addition, there may be headache, tachycardia and dizziness in cases of spinal cord aplasia.

Is bone marrow aplasia cancer?

Medullar aplasia is not cancer.Although leukemia is a type of cancer that affects blood cells, there is an alteration in the marrow that allows the marrow to produce and release more cells of a certain cell lineage or to release cells that have not yet undergone a maturation process, such as myelocytes, for example. example.

In the case of medullary aplasia, the medulla actually loses its function, that is, the cells are produced in a much smaller amount or there may simply be no production.

Possible causes of spinal cord aplasia

The causes of bone marrow aplasia are not always known, but it is usually related to:

  • Prolonged exposure to radiation;
  • Use of cytotoxic drugs;
  • Exposure to benzene derivatives;
  • Exposure to insecticides;
  • Infections;
  • Use of medications such as chloramphenicol, for example;
  • Autoimmune diseases.

Rarely, spinal aplasia is hereditary, but when it happens, it is usually related to Fanconi anemia, which is a serious, genetic and rare disease in which the child has malformations, which can be observed at birth, spots on the skin, renal impairment, short stature and more chances of developing tumors and leukemia. Understand how to identify and treat Fanconi anemia.

How the diagnosis is made

The diagnosis of medullary aplasia is made by means of a blood test indicated by the hematologist or general practitioner, the hemogram, in which the amounts of red blood cells, leukocytes and platelets circulating in the blood can be verified.

In addition, the doctor may request a myelogram, which is a slightly more invasive test in which blood and marrow are aspirated from the hip bone or sternum to check how it is being the production of blood cells.See what the indications are and how the myelogram is performed.

How the treatment is done

Treatment for medullary aplasia should be guided by the doctor, it can vary according to the degree of aplasia and aims to promote an increase in the amount of circulating blood cells. For this, the doctor may recommend the following treatments:

  • Immunosuppression therapy, which is usually done using a serum containing antibodies against T cells, this type of treatment is also known as thymotherapy. In this way, it is possible to reduce the activity of the immune system, regulating the production of blood cells, however the result of this treatment is not lasting, and bone marrow transplantation is usually indicated to achieve a cure;
  • Bone marrow transplantation,in which the bone marrow cells from the donor (he althy) are transplanted into the sick person, so that orderly production of blood cells is stimulated.It is important that the patient undergoing bone marrow transplantation is properly monitored by the doctor so that it is possible to guarantee the cure. Understand how bone marrow transplantation is performed.

In addition to these treatments, it is also important to carry out supportive treatment, which aims to prevent and combat other situations that may have occurred as a result of spinal aplasia and, thus, promote the person's quality of life. Thus, the physician may recommend the use of antibiotics to treat and/or prevent secondary infections, as well as blood transfusions, since many patients with medullary aplasia have recurrent anemia.

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