Aplastic Anemia: Etiology (Pediatric Nursing)

00:01 Now we cover aplastic anemia.

00:03 Aplastic anemia is where the stem cells in the bone marrow are suppressed.

00:07 The bone marrow normally makes the blood cells including the platelets, the red blood cells and the white blood cells but here in the setting of aplastic anemia, this process is disrupted and the bone marrow goes into failure.

00:19 Here you can see that if the bone marrow is in failure, it's not gonna be contributing in a meaningful way to creating these new blood cells including the red blood cells, the white blood cells and the platelets.

00:30 The patient will develop a pancytopenia which means it's a decrease in all of the cell types.

00:35 Remember pan- means "all", -cyto- means "cell" and -penia means "low", so "all cells are low".

00:42 Tthe patient will have a normocytic normochromic anemia which means the cells are the right size and they have the right amount of hemoglobin there just aren't enough in total.

00:53 The bone marrow's gonna slow the development of these new blood cells and it's gonna become aplastic or empty or hypoplastic where it just has a few cells.

01:03 There are multiple causes of aplastic anemia.

01:05 This can be a sudden onset or slow development It can be mild or severe and it can lead to serious medical conditions and it can even be life-threatening.

01:15 First let's do an overview of the causes and then will delve deeper.

01:19 There are primary and secondary causes of aplastic anemia.

01:23 These are the primary causes.

01:25 To start, most causes are idiopathic which means the cause is unknown and there is no history of exposure to other substances or causative agents.

01:33 The other primary cause of aplastic anemia is called Fanconi anemia and this disorder usually becomes symptomatic around age 5 as the bone marrow becomes more hypoplastic These are also the secondary causes of bone marrow failure that can cause aplastic anemia.

01:49 Medications - examples are those to treat rheumatoid arthritis and some antibiotics.

01:55 Viral infections.

01:56 Viruses have been linked to the development of aplastic anemia and these include Hepatitis,the Epstein-Barr virus, Cytomegalovirus, Parvovirus B19 and HIV.

02:07 Pregnancy.

02:08 Aplastic anemia can occur in pregnancy and this can be related to an autoimmune problem.

02:13 Your immune system can attack your bone marrow during pregnancy.

02:17 Toxins such as chemotherapy, radiation and chemicals.

02:21 Hematopeitic cells are especially susceptible to ionizing radiation and with the sublethal doses, the bone marrow can eventually recover.

02:28 During treatments for cancer, the bone marrow's healthy stem cells are also gonna be damaged along with the targeted cancer cells Aplastic anemia can be a temporary side effect of these treatments.

02:39 In addition, exposure to toxic chemicals such as those used in pesticides and insecticides.

02:44 These can cause aplastic anemia.

02:46 Exposure to benzene and ingredient gasoline has also been linked.

02:50 This type of anemia will resolve spontaneously if you avoid the repeated exposure to these chemicals.

02:56 Here we see possible triggers for aplastic anemia and these will result in disorders of the pluripotent stem cell and cause a decreased production in the red blood cells, white blood cells and platelets.

03:07 So idiopathic, this is the most common cause.

03:10 Aplastic anemia can be acquired or inherited although most cases are acquired.

03:15 Inherited forms usually present during the first decade of life.

03:19 Idiopathic causes of aplastic anemia remain a mystery but it's believed to be an immune mediated attack directed at these hematopoeitic stem cells.

03:28 Then the T-cells, a type of white blood cell is gonna target the hematopoeitic stem cells and will kill these cells.

03:34 Finally. the lymphocytes are gonna suppress the blood cell production and division in the marrow.