已阅读5页,还剩11页未读, 继续免费阅读
版权说明:本文档由用户提供并上传,收益归属内容提供方,若内容存在侵权,请进行举报或认领
文档简介
,Aplastic anemia(AA),Definition,Aplastic anemia is a life-threatening syndrome characterized by failure of the bone marrow to produce peripheral blood cells and their progenitors.,Etiology and pathogenesis,The major causes for aplastic anemia: 1.Infections (e.g. Hepatitis, Epstein-Barr virus and Parvovirus B19). 2.Radiation X rays, rays 3.Chemicals:benzene 4.Drugs:Chloramphenicol(氯霉素),Immune-Mediated injury is the main pathogenesis. In addition, absent or defective hematopoietic stem cells and abnormal bone marrow microenviroment can also cause aplastic anemia.,Clinical manifestation and classification,Clinical manifestation Anemia ,Bleeding and Infections are common symptomsClassification1.Severe Aplastic anemia(SAA)2.Non-severe Aplastic anemia(NSAA),Physical Examination,1.Petechiae and ecchymoses are typical.,2.Pallor of the skin and mucous membranes is common.,Laboratory Studies,1.Blood Smear: Pancytopenia (anemia, leukopenia, and thrombocytopenia) is a universal presenting finding.,SAA blood smear,Normal peripheral blood smear,2.bone marrow biopsy:,Biopsy is superior for determination of cellularity and shows mainly fat under the microscope, with hematopoietic cells occupying 25% of the marrow space; in the most serious cases the biopsy is virtually 100% fat. It is required to establish the diagnosis.,A.Normal bone marrow biopsy. This specimen shows an abundance of hematopoietic cells, including Myeloid and erythroid precursors and Normal-appearing megakaryocytes,B. Aplastic anemia biopsy. This specimen shows few detectable hematopoietic cells, and those that can be seen (one small nest) are largely lymphocytes.,3.Bone marrow smear,The bone marrow is usually readily aspirated but dilute on smear, and the fatty biopsy specimen may be grossly pale on withdrawal; In severe aplasia the smear of the aspirated specimen shows only red cells, residual lymphocytes, and stromal cells.,D,D.Marrow smear in aplastic anemia. The marrow shows replacement of hematopoietic tissue by fat and only residual stromal and lymphoid cells.,C. Normal bone marrow aspirate smear. The marrow is normally 3070% cellular, and there is a heterogeneous mix of myeloid, erythroid, and lymphoid cells.,C,Reference standard of diagnosis for AA,1.Peripheral blood pancytopenia, reticulocyte percentage less than 0.01 and the ratio of Lymphocyte is increased. 2.Generally,without the liver and spleen enlargement.3.At least one area of hypoplasia in bone marrow. Non-hematopoietic cells increase .4. Elimination of other diseases which may cause pancytipenia such as PNH, MDS, acute arrest of hemopoiesis,etc.5.Common therapy for anemia is ineffective.,SAA laboratory criteria,To define SAA there must be at least two of the following: (1) absolute neutrophil count less than 0.5 109/L, (2) platelet count less than 20 109/L, or (3) reticulocytes less than 20 109/L. Non-severe AA:Patients not fulfilling the criteria for severe aplastic anaemia.,Treatment,Hematopoietic Stem Cell Transplantation This is the best therapy for the young patient with a fully his
温馨提示
- 1. 本站所有资源如无特殊说明,都需要本地电脑安装OFFICE2007和PDF阅读器。图纸软件为CAD,CAXA,PROE,UG,SolidWorks等.压缩文件请下载最新的WinRAR软件解压。
- 2. 本站的文档不包含任何第三方提供的附件图纸等,如果需要附件,请联系上传者。文件的所有权益归上传用户所有。
- 3. 本站RAR压缩包中若带图纸,网页内容里面会有图纸预览,若没有图纸预览就没有图纸。
- 4. 未经权益所有人同意不得将文件中的内容挪作商业或盈利用途。
- 5. 人人文库网仅提供信息存储空间,仅对用户上传内容的表现方式做保护处理,对用户上传分享的文档内容本身不做任何修改或编辑,并不能对任何下载内容负责。
- 6. 下载文件中如有侵权或不适当内容,请与我们联系,我们立即纠正。
- 7. 本站不保证下载资源的准确性、安全性和完整性, 同时也不承担用户因使用这些下载资源对自己和他人造成任何形式的伤害或损失。
最新文档
- 石化企业安全课件
- 急诊科心肺复苏技能测试题库及答案详解
- 环境科学必修三Unit2环保知识测试答案
- 广西安全员考试高频考点与题库试题结合解析
- 开学精神测试题及答案助你快速适应新学期
- 建筑结构设计原理测试题库及解析答案
- 快捷键实战演练手册测试题及答案全收录
- 建筑设计理念与方案选择题及答案
- 机器学习算法中的循环优化与极限问题解析
- 健康饮食计划挑战题目及解答
- (一模)温州市2026届高三第一次适应性考试化学试卷(含答案)
- 2024年全国网络安全行业职业技能大赛(网络安全管理员)考试题库-上(单选题)
- 中药学类专业大学生职业生涯规划书
- 茂名市恒兴养殖有限公司江湖镇龙梅生产基地建设项目环评报告
- 滑触线施工方案
- 小学二年级上册书法教案
- 2019电网通信网络运行班组标准化管理手册
- 垃圾池施工方案
- 儿内科神经肌肉系统疾病诊疗规范2023版
- 黔江武陵山机场改扩建项目飞行区场道工程施工组织设计
- 全民健康体检(行业一类)课件
评论
0/150
提交评论