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Hematologist, oncohematologist

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Diagnosis of aplastic anemia

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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Plan for examination of patients with aplastic anemia

Clinical analysis of blood, with the determination of the number of reticulocytes and DC.
Hematocrit.
Blood type and Rh factor.
Myelograms from 3 anatomically different points and trepanobiopsy, determination of colony-forming properties and cytogenetic analysis in hereditary variants of the disease.
Immunological examination: determination of antibodies to erythrocytes, platelets, leukocytes, determination of immunoglobulins, typing according to the HLA system, RBTL.
Biochemical blood test with determination of ALT, ACT, bilirubin, total protein, proteinogram, urea, creatinine, sugar, haptoglobin, fetal hemoglobin.
Clinical examination: urinalysis, coprogram, sowing feces, smears from the pharynx and nose, examination of the ENT doctor, dentist, ECG, chest x-ray (to exclude thymoma, hemosiderosis), bones of the skull, wrist.
Transfusiologic anamnesis: the number and frequency of blood transfusions, including from relatives; posttransfusion reactions.
According to indications: ultrasound of internal organs, intravenous urography, coagulogram, "iron-complex" of blood, functional tests of kidneys, etc.
In patients with Fanconi anemia:
- to confirm the diagnosis - a test with diepoxybutane or mitolysin
- in patients with established diagnosis
1. assessment of endocrine status
  - evaluation of sexual development
  - test for glucose tolerance
  - level of growth hormone
  - thyroid hormone levels
2. X-ray examination
  - elimination of malformations of the osseous system
  - exclusion of anomalies of the urogenital tract
3. functional hepatic assays
4. functional renal tests
5. Heart ultrasound
6. audiogram
7. examination of family members of the patient
  - The exclusion of Fanconi anemia from other relatives
  - Survey of relatives to identify a potential bone marrow donor
  - cytogenetic examination of relatives and patients
  - complementarity study of the patient's genes
8. Periodically examining the bone marrow to exclude transformation into myelodysplastic syndrome or acute leukemia.

trusted-source [1], [2], [3], [4], [5], [6], [7], [8]