Aplastic anaemia in adults
Resumo
Definición
Anamnesis y examen
Principales factores de diagnóstico
- presence of risk factors
Otros factores de diagnóstico
- history of recurrent infection
- fatigue
- pallor
- history of bleeding or easy bruising
- tachycardia
- dyspnoea
- persistent warts
- hearing loss or deafness
- short stature, pigmentation abnormalities, or urogenital abnormalities
- nail malformations, reticular rash, oral leukoplakia, or epiphora
- osteoporosis
- premature hair loss/premature greying
- hyperhidrosis
- dysphagia
- extensive dental caries or tooth loss
- steatorrhoea
- skeletal dysplasia
- monocytopenia
- non-tuberculous mycobacterial infections
- pulmonary alveolar proteinosis
- congenital lymphoedema, Emberger syndrome
- immunodeficiency (DCML [dendritic cell, monocyte, B and NK lymphoid deficiency])
Factores de riesgo
- drug or toxin exposure
- paroxysmal nocturnal haemoglobinuria (PNH)
- recent hepatitis
- pregnancy
- autoimmune disease
- family history
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- full blood count and peripheral blood smear
- reticulocyte count
- bone marrow biopsy and cytogenetic analyses
Pruebas diagnósticas que deben considerarse
- serum B12 and folate levels
- virus testing
- liver function tests (LFTs)
- autoantibody screen
- flow cytometry for glycosylphosphatidylinositol-anchored proteins
- chest x-ray
- abdominal ultrasound
- appropriate genetic tests
- computed tomography scan
Algoritmo de tratamiento
non-severe acquired disease
severe/very severe acquired disease
inherited marrow failure syndrome
Colaboradores
Autores
Austin G. Kulasekararaj, MD, MRCP, FRCPath
Consultant Haematologist and Honorary Senior Clinical Lecturer
Department of Haematological Medicine
King's College Hospital NHS Foundation Trust and King’s College London
London
UK
Divulgaciones
AGK reports consulting fees or honoraria for lectures, presentations, speakers’ bureaus, and advisory boards from Agios, Alexion, Amgen, Biocryst, Celgene/Bristol-Myers Squibb, Novartis, Pfizer, NovoNordisk, Roche, Samsung, and Sobi. He is an author of references cited in this topic. AGK is the unpaid chairman of the writing committee of the British Society of Haematology guidelines on diagnosis and management of adult aplastic anaemia.
Agradecimientos
Dr Kulasekararaj would like to gratefully acknowledge the assistance of Professor Judith C. W. Marsh, Dr Ziyi Lim, Dr Philippe Armand, and Professor Joseph H. Antin, previous contributors to this topic. ZL, PA, and JHA declared that they had no competing interests. JCWM has received fees for consulting for Novartis Global, Amgen, Alexion, Jazz Pharmaceuticals, and GSK and has also consulted for Pfizer and Sanofi; received a fee for lectures given for Novartis and has also given lectures for Alexion and Sanofi; was awarded a research grant from Sanofi for King’s College London and has received a research grant from Novartis Global; and has received travel expenses from Novartis and Adienne to attend meetings.
Revisores por pares
Christoph Pechlaner, MD
Associate Professor of Medicine
Innsbruck Medical University
Innsbruck
Austria
Declarações
CP declares that he has no competing interests.
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Referências
Principais artigos
Kulasekararaj A, Cavenagh J, Dokal I, et al. Guidelines for the diagnosis and management of adult aplastic anaemia: a British Society for Haematology Guideline. Br J Haematol. 2024 Mar;204(3):784-804.Texto completo Resumo
Townsley DM, Dumitriu B, Young NS. Bone marrow failure and the telomeropathies. Blood. 2014 Oct 30;124(18):2775-83.Texto completo Resumo
Artigos de referência
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- Guidelines for the diagnosis and management of adult aplastic anaemia: a British Society for Haematology Guideline
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