Aplastic Anemia in Children
Aplastic anemia is a serious
condition in which the bone marrow doesn’t make enough new blood cells. With fewer
cells, a child with aplastic anemia has:
- Less oxygen sent to organs, tissues,
and cells (from too few red blood cells)
- Increased risk of infection (from too few white blood cells)
- Increased risk of bleeding problems (from too few platelets)
Aplastic anemia in children has
many causes. Sometimes the cause is unknown. There are many known causes. Aplastic
anemia may develop it at some point during childhood. Or it may be passed down from
parent to child.
Acquired causes include:
Infection.These include hepatitis or liver infection, and many different viral illnesses,
such as Epstein-Barr virus (EBV), cytomegalovirus (CMV), parvovirus B19, or human
immunodeficiency virus (HIV).
Cancer. Some cancers affect the bone marrow.
These include lupus and rheumatoid arthritis.
Medicines. This includes some antibiotics and other medicines.
Toxins. These include heavy metals, pesticides, and benzene.
therapy and chemotherapy.
These are done to treat cancer.
The most common symptoms of
aplastic anemia are below.
Low levels of red blood cells can cause:
- Pale skin
- Chest pain
- Irregular heart beat
- Enlarged heart
Low levels of white blood cells can cause:
- Mouth sores
Low levels of platelets can cause:
- Easy bruising
- Bleeding gums
- Blood in the stool
- Heavy bleeding with menstrual periods
Other symptoms can include:
The symptoms of aplastic anemia may
look like other blood disorders or medical problems. Always check with your
child's doctor for a diagnosis.
Your child's healthcare provider
will likely refer your child to a hematologist, an expert in blood disorders. Along
a complete medical history and physical exam of your child, tests for aplastic anemia
Hemoglobin and hematocrit.
This blood test measures the amount of hemoglobin, the part of red blood cells that
carry oxygen, and red blood cells in the blood.
Complete blood count (CBC). A
complete blood count checks the red and white blood cells, blood clotting cells
(platelets), and sometimes, young red blood cells (reticulocytes). It includes
hemoglobin and hematocrit and more details about the red blood cells.
Peripheral smear. A small
sample of blood is examined under a microscope. Blood cells are checked to see if
they look normal or not.
Bone marrow aspiration or
This procedure is done by taking a small amount of bone marrow fluid
(aspiration) or solid bone marrow tissue, called a core biopsy. The hip bone is often
used. The fluid and tissue are examined for the number, size, and maturity of blood
cells or abnormal cells.
Treatment will depend on your child’s symptoms, age, general health, and how severe
the condition is. Treatment for aplastic anemia also depends on the cause. For mild
aplastic anemia, treatment may not be needed. Treatment may include:
- Blood transfusions
- Platelet transfusions
- Hormones or other medicines (to stimulate the bone marrow to produce cells)
- Immunosuppressive medicine
- Stem cell transplant
With correct treatment, the risk of
complications will be reduced for children with aplastic anemia.
Complications of aplastic anemia
- Medicine used to treat anemia may cause side effects
- Problems with growth and development
- Heart failure
- Uncontrolled bleeding
- Severe infections
Work with your child's healthcare provider to develop a treatment plan.
- Try to make your child's life as normal as possible.
- Remember to also pay attention to other children in the family.
- Work closely with your child’s school to make sure he or she gets what is needed.
- Your child may also qualify for special programs under Section 504 of the Rehabilitation
Act of 1973.
- If your child feels different or alone, find a support group for children with anemia.
Your child should not do activities
that increase the chance of infection or bleeding. These activities include things
- Staying away from people who are sick
- Eating uncooked foods
- Contact sports (for example, football, hockey, skiing, or rollerblading)
- Traveling to high altitudes (children with a low red blood cell count will have increased
fatigue and need for oxygen in high altitudes)
When to Call a Healthcare Provider
Each child is different based on
how severe their symptoms are and what treatment they may be getting. Talk with your
child's healthcare provider about when you should call. For instance, you may be
instructed to call if your child has:
- Signs of infection, such as a fever,
or flu-like symptoms
- Bleeding that you can't control
- Increased tiredness
- Aplastic anemia is a serious condition in which the bone marrow does not produce enough
new blood cells.
- It may be passed down from the parents or develop sometime during childhood.
- Some symptoms include tiredness, paleness, frequent infections, and easy bruising
- Aplastic anemia is diagnosed with blood and bone marrow tests.
- Treatment depends on the cause. It may include blood transfusions, medicines, and
stem cell transplantation.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s
provider after office hours. This is important if your child becomes ill and you have
questions or need advice.