Aplastic anemia is a rare but serious condition that occurs when a child's bone marrow produces too few of the three types of blood cells: red cells that carry oxygen, white cells that fight infection and platelets that prevent bleeding. This occurs because the child's bone marrow fails to produce enough stem cells, the basic cells that give rise to the three blood cell types.
The low number of red cells causes a drop in hemoglobin, the protein in red blood cells that carries oxygen to tissues of the body. A low number of white cells makes a child very susceptible to infections. And a low number of platelets causes bruising and bleeding because the blood will not clot normally.
Aplastic anemia in children may have many causes, such as a previous illness or infection. But in 50 percent to 75 percent of cases, the reason for the condition isn't known. Causes may include:
Children also may inherit a disorder that increases their risk of developing aplastic anemia. Some disorders known to increase the risk of developing the condition include:
Aplastic anemia is suspected when test results indicate that all three blood cell levels are extremely low, but the cells themselves have a relatively normal appearance. It remains a rare disease, striking only two to six out of every one million people annually in the United States and Europe.
In addition to low blood cell counts, aplastic anemia is characterized by other physical symptoms of anemia such as pale skin and fingernails, rapid pulse, heart murmur and fatigue. Children also may exhibit abnormal bleeding including multiple bruises, nosebleeds, bleeding gums and small hemorrhages under the skin as well as infection, especially fever. However, each child may experience symptoms differently. Other possible symptoms include:
The symptoms of aplastic anemia may resemble other blood disorders or conditions, so in addition to a complete medical history and a thorough physical examination, the following diagnostic tests will be performed:
These tests usually are performed together. A pediatric hematologist, a doctor who specializes in blood disorders in children, usually will confirm the diagnosis based on the results.
Specific treatments for aplastic anemia will be determined by your child's doctor based on the following:
Treatment for aplastic anemia usually depends on the underlying cause. For certain causes, recovery can be expected after treatment. However, relapses can occur. If all treatments fail, aplastic anemia can be fatal.
Reviewed by health care specialists at UCSF Benioff Children's Hospital.