Aplastic crisis: Difference between revisions
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*[[Sickle cell crisis]] | *[[Sickle cell crisis]] | ||
*[[Anemia]] | *[[Anemia]] | ||
*Increased fatigue, pallor | *Increased [[fatigue]], pallor | ||
*Activity intolerance | *Activity intolerance | ||
*Shortness of breath | *[[Shortness of breath]] | ||
==Causes== | ==Causes== | ||
*[[Erythema Infectiosum (Fifth disease)]] | *[[Erythema Infectiosum (Fifth disease)]] | ||
**Invades and destroys red blood cell precursors and halts the red cell production | **Invades and destroys red blood cell precursors and halts the red cell production | ||
*EBV | *[[EBV]] | ||
*Strep infection | *[[Strep]] infection | ||
*Use of hydroxyurea | *Use of [[hydroxyurea]] | ||
==Labs== | ==Labs== | ||
*CBC with retic count | *CBC with retic count | ||
**Decrease from baseline hemoglobin/hematocrit | **[[anemia|Decrease from baseline hemoglobin/hematocrit]] | ||
**Precipitous drop in reticulocyte count (or lack of response) | **Precipitous drop in reticulocyte count (or lack of response) | ||
==Management== | ==Management== | ||
* | *[[pRBCs|Transfusion]] using extended antigen-typed, leuko-depleted pRBCs | ||
*Droplet precautions | |||
==Recovery Phase== | ==Recovery Phase== | ||
*Typically in 1-2 weeks | *Typically in 1-2 weeks | ||
*Often marked by hyperbilirubinemia, and called a “hyperhemolytic” phase<ref>http://www.ihtc.org/medical-professionals/blood-disorders/sickle-cell-disease/aplastic-crisis-intervention/</ref> | *Often marked by hyperbilirubinemia, and called a “hyperhemolytic” phase<ref>http://www.ihtc.org/medical-professionals/blood-disorders/sickle-cell-disease/aplastic-crisis-intervention/</ref> | ||
==Disposition== | |||
*Admit | |||
==Also See== | ==Also See== | ||
Latest revision as of 23:40, 30 September 2019
Background
- Also called Reticulocytopenia: abnormal decrease of reticulocytes in the body
- Clinically common in Sickle cell crisis and Hereditary Spherocytosis (HS)
Clinical Features
- Sickle cell crisis
- Anemia
- Increased fatigue, pallor
- Activity intolerance
- Shortness of breath
Causes
- Erythema Infectiosum (Fifth disease)
- Invades and destroys red blood cell precursors and halts the red cell production
- EBV
- Strep infection
- Use of hydroxyurea
Labs
- CBC with retic count
- Decrease from baseline hemoglobin/hematocrit
- Precipitous drop in reticulocyte count (or lack of response)
Management
- Transfusion using extended antigen-typed, leuko-depleted pRBCs
- Droplet precautions
Recovery Phase
- Typically in 1-2 weeks
- Often marked by hyperbilirubinemia, and called a “hyperhemolytic” phase[1]
Disposition
- Admit
Also See
References
- Janz TJ, Hamilton GC: Anemia, Polycythemia, and White Blood Cell Disorders, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 119:p 1568-1574.
- http://www.ihtc.org/medical-professionals/blood-disorders/sickle-cell-disease/aplastic-crisis-intervention/ - last accessed 1/6/15