What is hepatic anemia

Anemia means that there is too little hemoglobin in the body. Generally, malnutrition in children will cause anemia because the body develops too quickly and the nutrition consumed cannot meet the needs of growth. At this time, they should eat more iron-rich foods, such as animal liver, peanuts, red dates, etc. Aplastic anemia means that the hematopoietic stem cells in the body are hindered in the hematopoietic process. So, what specific disease is it? Let's learn about it below.

Aplastic anemia, also known as AA, is a group of bone marrow hematopoietic failure syndromes caused by multiple causes. It is characterized by decreased proliferation of bone marrow hematopoietic cells and cytopenia in peripheral blood. The main clinical manifestations are anemia, bleeding and infection. The exact cause of the disease has not yet been determined. The onset of aplastic anemia may be related to chemical drugs, radiation, viral infection and genetic factors. Aplastic anemia is mainly seen in young and middle-aged people, and there are two peak periods of incidence, namely the age group of 15 to 25 years old and the elderly group over 60 years old. The incidence rate in men is slightly higher than that in women. Depending on the severity of bone marrow failure and the progression of the clinical course, it is divided into severe and non-severe aplastic anemia, as well as acute and chronic aplastic anemia.

1. Medication

It is the most common cause of disease.

2. Chemical poisons

The relationship between benzene and its derivatives and aplastic anemia has been confirmed by many experimental studies. Benzene is easily fixed in fat-rich tissues when it enters the human body. In chronic benzene poisoning, benzene is mainly fixed in the bone marrow. The bone marrow toxicity of benzene is caused by its metabolites, which can act on hematopoietic progenitor cells, inhibit the synthesis of their DNA and RNA, and damage chromosomes.

3. Ionizing radiation

X-rays, gamma rays or neutrons can pass through or enter cells and directly damage hematopoietic stem cells and the bone marrow microenvironment. Long-term radiation exposure exceeding the permitted amount (such as radiation source accidents) can cause aplastic anemia.

4. Viral infection

The relationship between viral hepatitis and aplastic anemia has been confirmed, which is called viral hepatitis-associated aplastic anemia, and is one of the most serious complications of viral hepatitis. The type of hepatitis that causes aplastic anemia has not yet been confirmed, and it is mostly caused by seronegative hepatitis.

5. Immune factors

Aplastic anemia can be secondary to thymoma, systemic lupus erythematosus and rheumatoid arthritis, etc., and antibodies that inhibit hematopoietic stem cells can be found in the patient's serum. Some cases of aplastic anemia of unknown cause may also involve immune factors.

6. Genetic factors

Fanconi anemia, dyskeratosis congenita, and Schwachman-Diamond syndrome are mostly autosomal recessive genetic diseases and are familial.

7. Paroxysmal nocturnal hemoglobinuria (PNH)

PNH and aplastic anemia are closely related, as both are diseases of hematopoietic stem cells. A clear transition from aplastic anemia to PNH, but the symptoms of aplastic anemia are no longer obvious; or a clear transition from PNH to aplastic anemia, but the symptoms of PNH are no longer obvious; or PNH combined with aplastic anemia and aplastic anemia combined with PNH red blood cells, can all be called aplastic anemia-PNH syndrome.

8. Other factors

There are rare case reports of aplastic anemia occurring during pregnancy, resolving after delivery or induced abortion, and then recurring during a second pregnancy, but most people believe that this may be a coincidence. In addition, aplastic anemia can also be secondary to chronic renal failure, severe hypothyroidism or anterior pituitary dysfunction, etc.

Clinical manifestations

1. Acute aplastic anemia

The disease has an acute onset and progresses rapidly, with bleeding and infectious fever often being the first and main manifestations. Anemia is often not obvious at the beginning of the disease, but it becomes progressive as the disease progresses. Almost all of them have a tendency to bleed, and more than 60% have internal bleeding, mainly manifested as gastrointestinal bleeding, hematuria, fundus hemorrhage (often accompanied by visual impairment) and intracranial hemorrhage. Skin and mucous membrane bleeding is extensive, severe, and difficult to control. Fever is almost always present during the course of the disease, which is caused by infection. Necrotic ulcers often occur in the oropharynx and around the anus, leading to sepsis. Pneumonia is also common. Infection and bleeding are mutually causal, making the condition worse.

2. Chronic aplastic anemia

The onset is slow, with anemia as the first and main manifestation; bleeding is mostly limited to the skin and mucous membranes and is not serious; infection may occur, but it is often mainly in the respiratory tract and is easy to control. If the treatment is appropriate and persistent, many patients can achieve long-term relief or even recovery, but some patients will suffer from the disease for many years or even for decades. A few will progress to severe or very severe aplastic anemia in the later stages.