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Tuesday, October 4, 2011

Aplastic anaemia- Lab diagnosis, Treatment, Cause of High ESR

Laboratory diagnosis of aplastic anaemia:


1. Routine haematological tests:

                -Haemoglobin-Reduced, maybe even less than 3g/dl.
                -MCV, MCH, MCHC are all normal
                -Erythrocyte sedimentation rate (ESR) is high(60-100 mm In first hour)
                -Peripheral blood film:
                                Leishmen stain:
                                                RBC: Normocytic normochromic with anisocytosis and poikilocytosis






2. Bone marrow tests(Confirmatory):

                -Cellularity: Decreased
                -Myeloid : Erythroid ration: Normal
                -Erythropoiesis: Decreased
                -Granulopoiesis-Decreased
                -Megakaryopoiesis: Decreased
                -Plasma cells-Increased
                -Reticular cells-Increased
                -Iron content-Increased

Why ESR is so high in aplastic anaemia:

The fundamental pathological picture of aplastic anaemia is a reduction in the amount of haematopoietic tissue causing an inability to produce normal number of mature cells for discharge into the blod. So, RBC count becomes very low in relation the plasma volume. So ESR is markedly high(60-100 mm in first hour).

What is the treatment of aplastic anaemia:

1. Supportive treatment

                -Blood and blood product transfusion
                -Control of infection

2. Immunosuppressive therapy:

                -Ciclosporin
                -Anti-thymocyte globulin

3. Allogenic bone marrow transplantation-Effective below 30 years of age.


Reference : In the making of the above article the follwing books were used:



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