Aplastic anemia Diagnosis

The doctor diagnosed aplastic anemia based on patient medical history, a physical exam, CBC and bone marrow biopsy. Then according to test results to decide the appropriate treatment.

Medical and family history:
The doctor will ask detailed questions about many kinds of condition that could cause anemia, such as whether you have been exposed to drugs, chemicals, toxic, benzene or radiation. And also ask whether your family members have inherited aplastic anemia.

Physical Exam:
Your doctor will do a physical exam to check for signs of aplastic anemia and find out how severe the disorder. This tests check pale, shortness of breath, pale skin, bleeding or bruising and more.

Two tests are used to diagnose aplastic anemia (include complete blood count and bone marrow biopsy). The purpose for testing are to:

• Confirm a diagnosis of aplastic anemia and look for its cause
• Rule out blood cancers that can cause bone marrow failure
• Determine the severity of the aplastic anemia
• Check for the presence of paroxysmal nocturnal hemoglobinuria

The first is a complete blood count (CBC). In aplastic anemia this test will show that the red cell count, white cell count, and platelet count are low. Abnormal results may be a sign of aplastic anemia, an infection, or another condition. This test also checks your hemoglobin and hematocrit levels. Hemoglobin is an iron-rich protein in red blood cells that carries oxygen to the body. Hematocrit is a measure of how much space red blood cells take up in your blood. A low level of hemoglobin or hematocrit is a sign of anemia. The last, CBC check MCV. MCV is a measure of the average size of your red blood cells. The results may be a clue as to the cause of your anemia.

The next step is to look at the bone marrow in a test called a bone marrow biopsy. In aplastic anemia, the numbers of red blood cells, white blood cells and platelets in the blood are all low. There are two types of samples that can be collected from the bone marrow, that is aspiration and biopsy. A bone marrow aspiration uses a needle to extract a small amount of liquid marrow. A bone marrow biopsy uses a special needle to remove an intact core of marrow. Aspirations and biopsies are both usually taken from the back of the hip bone.

The marrow samples show low numbers of cells. The few cells that do appear are normal (not cancer cells). Based on the number of cells that appear, doctors diagnose the disease as moderate, severe or very severe aplastic anemia. Moderate aplastic anemia sometimes becomes severe over time, so doctors will watch for signs the disease is changing.

Additional tests may be used to help diagnose aplastic anemia, including blood tests, X-ray, CT scan, renal function and electrolytes, liver enzymes, thyroid function tests, vitamin B12 and folic acid levels.