Aplastic Crisis

Definition

Definition of Aplastic Crisis
An aplastic crisis should not be confused with hemolytic anemia, which is a constant feature of sickle cell disease. The aplastic crisis is temporary cessation of red cell production. Because of the markedly shortened red cell survival time in patients with sickle cell disease, a precipitous drop in hemoglobin occurs in the absence of adequate reticulocytosis.

Symptoms

Symptoms of Aplastic Crisis

1. Being very tired
2. Very pale (light in color) skin, lips or nails
3. Shortness of breath
4. Headaches
5. Fever
6. Fainting
7. Fast heartbeat
8. Not feeling well

Causes

Causes of Aplastic Crisis
Your body can stop making red blood cells when infected with a virus called parvovirus. This virus is different from the one found in dogs. It is a common virus among children. The virus is spread by people coughing or sneezing into the air. Most of the time you do not even know you were exposed to it. Parvovirus can be spread easily but is usually not harmful to others. However, it can cause problems in people who are pregnant or have sickle cell disease.

Diagnosis

Diagnosis of Aplastic Crisis
The diagnosis of transient aplastic crisis due to parvovirus B19 is often presumptive, based on a falling hemoglobin value and a low reticulocyte count in a patient with a hemolytic anemia. Specific DNA probes allow definitive diagnosis by PCR since the viremia is robust. A rising IgM antibody to the virus is another means of diagnosing parvovirus B19 infection.

Treatment

Treatment of Aplastic Crisis
Transient aplastic crisis usually is self-limiting and requires only supportive measures. Rare patients require more than a single transfusion to bridge the gap between marrow suppression and recovery. The fact that the BFU-E’s are not suppressed by the virus means that the bone marrow is poised for a rapid response once the virus is tamed. Rare patients will need immunoglobulin treatment, which is dramatically effective in reversing the aplasia. Immunoglobulin concentrate is the treatment of choice and is delivered as 0.4 g/kg/day for 5 days.

Prognosis

Prognosis of Aplastic Crisis
Consult with your doctor.

Prevention

Prevention of Aplastic Crisis
Consult with your doctor.