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Medicine

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Hematology

Question
2 out of 10
 

Aplastic anemia is seen in all of the following except.



A PNH
B Chloramphenicol

C Hepatitis A
D HIV-l

E Parvovirus

Ans. C

Hepatitis A (Ref. Hari- 17th Edi, Pg. 663)

Note: Hepatitis A is not a cause of Aplastic anemia.

Etiology of Aplastic Anemia

1. Idiopathic (more than 50%)

2. Drug – induced (dose dependent, idiosyncratic) Anticancer drugs

a. Antimicrobials (chloramphenicol, sulfonamides, penicillins)

b. Anticonvulsants (phenytoin, ethosuximide, carbamazepine)

c. Antithyroid agents (carbimazole, propylthiouracil)

d. Antidiabetic agents (tolbutamide, chlorpropamide)

e. Miscellaneous (gold compounds, D – penicillamine, bismuth, ticlopidine, thiocyanates, acetazolamide).

3. Chemical or toxin (benzene, carbon tetrachloride, insecticides)

4. Radiation

5. Infection (Non A, Non B, Non C hepatitis, EBV, parvovirus, tuberculosis, HIV)

(Ref. Cecil. 23rd ed., Table 171-1)

6. Pregnancy (remits following delivery in some)

7. Thymoma (usually associated with pure red cell aplasia)

8. Paroxysmal nocturnal hemoglobinuria (PNH develops in 5 – 10% of patients with aplastic anemia and 25% of patients with PNH develop aplastic anemia)

9. Constitutional (Fanconi’s anemia, familial aplastic anemia, dyskeratosis congenita)

10. Associated with myelodysplasia (patients with aplastic anemia may develop a myelodysplastic syndrome later).

11. Pernicious anemia

Fanconi's anemia is a congenital disorder responsible for a form of aplastic anemia. It is a cause of normocytic normochromic anemia.

Causes Of Aplastic Anemia (Ref. Cecil, 23rd ed., Table 171-1)

1. ACQUIRED

a. Drugs: antimetabolites, antimitotic agents, chloramphenicol, phenylbutazone, sulfonamides

b. Radiation

c. Chemicals: benzene, solvents, insecticides

d. Viruses: non-A, non-B, non-C hepatitis, Epstein-Barr virus

e. Paroxysmal nocturnal hemoglobinuria

f. Miscellaneous: pregnancy, connective tissue disorders

2. HEREDITARY

a. Fanconi anemia b. Dyskeratosis congenita c. Schwachman syndrome

3. IDIOPATHIC: 50–65% OF CASES

Hematology Flashcard List

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