Aplastic Anaemia Symptoms: Early Signs of Blood Cell Deficiency

Aplastic Anaemia Symptoms: How to Detect Blood Cell Deficiency

Aplastic anaemia symptoms include persistent fatigue and unexplained bruising and infections, resulting from the bone marrow's failure to produce blood cells. This rare blood disorder affects approximately 2–8 per million people annually, with a substantially higher incidence in India. Diagnosis involves blood counts and bone marrow examination, while treatment options range from immunosuppression to allogeneic stem‑cell transplantation.

Imagine your body’s blood factories shutting down, leaving you fatigued, prone to bruising and vulnerable to infections. This is the reality of aplastic anaemia. Affecting approximately 1.6 people per million each year worldwide, and occurring up to three times more frequently in South Asia, it is a condition that demands early recognition and expert care. Knowing the signs of aplastic anaemia symptoms is crucial in prompting timely diagnosis, which can save lives.

Read below to explore symptoms, causes and treatment for aplastic anaemia.

What are the symptoms of aplastic anaemia?

Aplastic anaemia symptoms may develop gradually and can vary from mild to severe. Some of the common symptoms include:

• Viral Infections: Frequent infections may occur due to neutropenia in aplastic anaemia, but viral infections are more often a trigger than a symptom.
• Fatigue: Low RBC count leads to reduced haemoglobin, limiting oxygen delivery to body tissues. This can cause persistent tiredness and lack of energy.
• Bruising Easily: reduced platelet production means the skin bruises more easily. These bruises also take longer to heal due to impaired clotting.
• Dyspnoea (Shortness of Breath):Individuals may feel short of breath even during mild exertion due to inadequate oxygen levels.
• Pale Skin: Low haemoglobin may cause the skin to appear unusually pale.
   

Aplastic anaemia symptoms in adults may also include dizziness, headaches, frequent fevers, oral thrush, nausea, bloody stools, nosebleeds, and gum bleeding. Since many of these symptoms overlap with other illnesses, accurate diagnosis by a medical professional is crucial.
 

What is Aplastic Anaemia?

Aplastic anaemia occurs when the bone marrow is unable to synthesise adequate red blood cells (RBCs), white blood cells (WBCs), and platelets. Generally, our blood consists of approximately 40–45% RBCs, 55% plasma, and about 1% WBCs. In this condition, doctors observe a noticeable drop in overall blood cell count, which can lead to severe complications. In India, 20-40% of pancytopenia cases are attributed to aplastic anaemia.

This condition also results in a reduction in haemoglobin levels—the molecules that transport oxygen in the blood. Consequently, individuals may be more susceptible to heart issues, bleeding disorders, serious infections, and related complications.

What Causes Aplastic Anaemia?

Doctors believe that your immune system mistakenly attacks the stem cells in your bone marrow. Bone marrow is the red, spongy substance present inside your bones. Stem cells present in the bone marrow synthesise blood cells. However, when they are damaged, they make fewer new blood cells.

Other than this, many medical conditions and treatments can also cause this. Let us look at the causes in detail.

• Immune System Dysfunction: In many cases, the immune system mistakenly attacks the stem cells within the bone marrow. These stem cells are responsible for creating all types of blood cells. When damaged, they cannot reproduce adequately, leading to a deficiency.
   
• Medical Conditions: Autoimmune disorders such as lupus can result in aplastic anaemia. In these conditions, the immune system targets healthy tissues, including bone marrow. Another example is paroxysmal nocturnal haemoglobinuria, a condition where RBCs break down too quickly, potentially causing aplastic anaemia symptoms.
  
  Viral infections like HIV, Epstein–Barr virus and parvovirus B19 have also been linked to this disorder. Pregnancy may, in rare cases, trigger aplastic anaemia as well.
   
• Medical Condition Treatments: Certain therapies, particularly those for autoimmune diseases and cancer, can lead to this disorder. Radiation therapy and chemotherapy, commonly used to treat cancers, can damage bone marrow cells. Long-term exposure to harmful chemicals such as benzene and arsenic is also a known risk factor.
   
• Inherited Conditions
   

Aplastic anaemia may also be caused by inherited bone marrow failure syndromes. These include:

• Dyskeratosis Congenita (approximately 50% prevalence)
• Shwachman–Diamond Syndrome (approximately 10-50% prevalence)
• Fanconi Anaemia
   

These genetic disorders impair bone marrow function and can result in significantly low blood cell counts.

How do Doctors Diagnose Aplastic Anaemia?

Doctors rely on a combination of physical exams and diagnostic tests. Diagnosis is based on established medical parameters and diagnostic criteria, including:

1. Previous Health Examination

Your doctor will begin with a physical examination and assess your medical history. Describing your symptoms in detail can help the doctor understand possible underlying causes and reach an accurate diagnosis.

2. Diagnostic Tests

Post-examination, your doctor may recommend a range of tests, such as:

• Complete Blood Count (CBC)
• Reticulocyte Count
• Erythropoietin (EPO) Test
• Iron Level Test
• Bone Marrow Biopsy and Aspiration
   

These tests help determine the extent of blood cell deficiency and evaluate bone marrow function.

How do doctors treat aplastic anaemia?

Treatment options generally depend on the aplastic anaemia symptoms and your overall health condition. Moreover, doctors consider the cause of aplastic anaemia while planning the appropriate treatment approach. So, here are some treatment options to consider:

• Allogeneic Stem Cell Transplantation: This treatment replaces damaged stem cells with healthy ones from a donor. Allogeneic stem cell transplantation offers high survival rates in younger patients with matched sibling donors, but outcomes vary by individual factors.
• Immunosuppressants: Since the condition often stems from an overactive immune system, immunosuppressive drugs like cyclosporine and anti-thymocyte globulin are used to slow immune responses.
• Blood Transfusions: Patients may require transfusions of red blood cells and platelets. White blood cell transfusions are rarely used and reserved for specific cases.
• Antibiotics: These are administered to prevent or treat infections, especially since patients have a weakened immune system.
   

How to Take Care of Yourself if You Have Aplastic Anaemia?

While medical treatment is essential, some key lifestyle changes can also support your recovery and daily well-being. Following are some ways to take care of yourself in this condition, other than medical treatments:

• Adopt a Healthy Diet: Include easily available Indian foods rich in iron and protein like spinach (palak), lentils (moong dal), lean meats, eggs, tofu, paneer, and seasonal fruits like guava and pomegranate.
• Avoid High-Contact Activities: Sports like football, hockey or cricket can increase the risk of injury and bleeding. Avoid such activities to protect yourself.
• Protect Yourself from Infections: Practise good hygiene like washing hands frequently, avoiding crowded places, and wearing a mask when necessary.
• Get Adequate Rest: Fatigue is a common symptom, so ensure you rest sufficiently to help your body recover and regenerate.
   

Final Words

Recognising aplastic anaemia symptoms is crucial for early intervention. Since the condition severely impacts the ability of the bone marrow to produce essential blood cells, it can lead to life-threatening complications if left untreated.

A timely and accurate diagnosis, followed by appropriate treatment, can significantly improve the quality of life and survival rate. Alongside medical intervention, adopting a healthy lifestyle, maintaining good hygiene, and avoiding risk factors can help in effectively managing the condition.