Many tests and tools are used to diagnose aplastic anemia aplastic anemia: (ay-PLASS-tik uh-NEE_mee-uh) A rare and serious condition in which the bone marrow fails to make enough blood cells - red blood cells, white blood cells, and platelets. The term aplastic is a Greek word meaning not to form. Anemia is a condition that happens when red blood cell count is low. Most… . These help to confirm the diagnosis, look for its cause and find out how severe it is. They are also used to rule out other conditions that may cause similar symptoms.
Medical History
To understand what is causing your symptoms and low blood counts, your doctor will take a detailed medical history. Your doctor may ask you questions like the following:
- What are your symptoms?
- What medications or herbal supplements have you been taking?
- Have you been exposed to harmful chemicals?
- Did you have chemotherapy chemotherapy: (kee-moe-THER-uh-pee) The use of medicines that kill cells (cytotoxic agents). People with high-risk or intermediate-2 risk myelodysplastic syndrome (MDS) may be given chemotherapy to kill bone marrow cells that have an abnormal size, shape, or look. Chemotherapy hurts healthy cells along with… or radiation treatments in the past?
- Is your urine dark or tea-colored in the morning?
- Has your liver been inflamed recently?
Providing a detailed health history helps your doctor give you an accurate diagnosis.
Blood Tests
Doctors conduct several types of blood tests to help them understand your case of aplastic anemia and create a treatment plan. Blood test results and lab reports are something every patient should learn how to read.
Complete Blood Count (CBC)
One key test is a complete blood count (CBC) complete blood count (CBC): A group of tests performed on a small amount of blood. The CBC measures the number of each blood cell type, the size of the red blood cells, the total amount of hemoglobin, and the fraction of the blood made up of red blood cells. Also called a CBC. . It uses a number of methods to measure how many of each blood cell type are in your blood sample. If the CBC shows a low number of red blood cells, white blood cells or platelets, your doctor may also do a blood smear test, which means examining your cells under a microscope.
Getting a CBC on a regular basis is important for aplastic anemia patients. It allows doctors to monitor blood counts over time and compare them with previous results. Based on this record, doctors can determine a patient’s progress and refine treatment plans accordingly.
Reticulocyte Count
A reticulocyte reticulocyte: An immature red blood cell. Reticulocytes are normally found in the bone marrow. They are present in the bloodstream only in very low numbers. count measures the number of young red blood cells in your blood. The test shows whether your bone marrow bone marrow: The soft, spongy tissue inside most bones. Blood cells are formed in the bone marrow. is making red blood cells at the correct rate. People who have aplastic anemia have low reticulocyte levels.
EPO level
EPO, or erythropoietin erythropoietin: (i-rith-row-POY-uh-tun) A protein made by the kidneys. Erythropoietin, also called EPO, is created in response to low oxygen levels in the body (anemia). EPO causes the bone marrow to make more red blood cells. A shortage of EPO can also cause anemia. , is a protein made by your kidneys. It is created in response to low oxygen levels in the body, typically caused by low red cell counts and anemia anemia: (uh-NEE-mee-uh) A condition in which there is a shortage of red blood cells in the bloodstream. This causes a low red blood cell count. Symptoms of anemia are fatigue and tiredness. . EPO causes your bone marrow to make more red blood cells.
Your doctor will order an EPO level to see if a shortage could be causing your anemia. A low EPO level may indicate a problem other than aplastic anemia, or it may make anemia worse in people who have MDS. Your doctor may prescribe a pharmaceutical form of EPO if yours is low.
Iron level
If you have anemia, your doctor may also check the level of iron in your blood. If a shortage of iron is causing anemia, it can be easily treated with iron supplements.
In some cases, blood tests may show that you have too much iron in your body. This is called iron overload iron overload: A condition that occurs when too much iron accumulates in the body. Bone marrow failure disease patients who need regular red blood cell transfusions are at risk for iron overload. Organ damage can occur if iron overload is not treated. . It can be caused by genetic conditions, or from getting lots of red blood cell red blood cell: The most numerous type of blood cell in healthy people. Red blood cells contain hemoglobin, a protein that picks up oxygen in the lungs and brings it to cells in all parts of the body. Also called erythrocyte, RBC. transfusions. There are a number of treatments that can remove iron from your body.
Vitamin B12 and folate levels
If you have red blood cells with an abnormal shape, size or look, your doctor will check your blood levels of vitamin B12 vitamin B12: A complex vitamin found in animal products. Vitamin B12 helps maintain healthy red blood cells and nerve cells. A shortage of Vitamin B12 and folate can reduce blood cell production in the bone marrow. Also called B complex vitamin. and folate folate: (FOE-late) A B-vitamin that is found in fresh or lightly cooked green vegetables. It helps the bone marrow make normal blood cells. Most people get enough folate in their diet. Doctors may have people with paroxysmal nocturnal hemaglobinuria (PNH) take a man-made form of folate called folic acid. (folic acid). A shortage of these vitamins can cause dysplasia, or cells that are not normal. These abnormal looking cells don’t work right, and this can lead to anemia.
Bone Marrow Tests
A bone marrow sample is usually a simple 30-minute procedure. The doctor removes some bone marrow aspirate (liquid bone marrow), typically from the pelvic or breast bone, with a hollow needle. A solid piece of bone marrow is also removed for a bone marrow biopsy bone marrow biopsy: A medical procedure to remove a small piece of solid bone marrow using a needle that goes into the marrow of the hip bone. The solid bone marrow is examined for cell abnormalities, the number of different cells and checked for scarring of the bone marrow. .
The doctor will look at your liquid bone marrow under a microscope and send a sample of your bone marrow to a lab.
A bone marrow test is done for two main reasons:
- To confirm a diagnosis of aplastic anemia
- To understand how well or poorly your bone marrow is making blood cells
The bone marrow test shows:
- The quantity (cellularity) of your bone marrow occupied by different cells
- Exactly what types and amounts of cells your bone marrow is making
- Increased, decreased, or normal levels of iron in your bone marrow
- Chromosomal (DNA) abnormalities
Learn more about the process of getting a bone marrow test.