Anaemia, Aplastic

Description

Medicine treatment

Referral

---

D60.0-1/D60.8-9/D61.0-3/D61.8-9

DESCRIPTION

Pancytopenia due to a hypoplastic bone marrow.

Clinical features:

• Pallor
• Purpura
• Petechiae
• Bleeding
• Frequent or severe infections

Pancytopenia in PLHIV B23.2 + (D61.2/D61.9)

Most common causes include:

• Direct effect of HIV.
• Medication (e.g. carbamazepine, valproic acid, phenytoin or pure red cell aplasia with emtricitabine and lamividine).
• Secondary opportunistic infections.
• Malignancies and nutritional deficiencies.

Many cases are idiopathic.

Investigations

• FBC and peripheral smear, Vitamin B₁₂ and red cell folate.
• Appropriate investigation to exclude opportunistic infections.
• Bone marrow trephine and aspiration in selected patients: where no other cause is found, in patients with persistent pancytopaenia, or to exclude infiltration with opportunistic infections, malignancies.

MEDICINE TREATMENT

If neutropenic and febrile, see Febrile neutropenia.

REFERRAL

• Discuss all cases of suspected aplastic anaemia with a specialist. (if necessary, stabilise patient with blood products in preparation for transport after consultation with an expert).

Click here for the pdf.

---

Standard Treatment Guidelines And Essential Medicines List For South Africa, Adult Hospital level_Version 1_30 March 2026

Chapter 2: Blood and Blood Forming Organs; 2.1.5 Anaemia, Aplastic