Anemia, Aplastic Crisis

Anemia, Aplastic Crisis

Jill S. Halterman, MD, MPH , George B. Segel, MD

Basic Information

Definition

Erythroid aplastic crisis is characterized by a relative failure of red blood cell production, usually in response to an infectious agent such as parvovirus.

ICD-9-CM Codes

284.8 Aplastic anemia—acquired
284.9 Aplastic anemia

Epidemiology & Demographics

• Children with the most significant hemolysis (i.e., the shortest red cell life span or highest reticulocyte percentage) are at highest risk for aplastic crisis. Transient aplasia has little effect in persons with no hemolysis and a normal red cell life span.
• Consider in all children with chronic hemolysis (e.g., sickle cell disease, hereditary spherocytosis, pyruvate kinase deficiency) who are evaluated for febrile illnesses.
• The frequency of aplastic crisis varies with the prevalence of erythrotropic viruses. When parvovirus is prevalent, aplastic crisis is a particular risk for those with chronic hemolysis.

Clinical Presentation

History

• Acute onset of pallor or fatigue, or both, especially in patients with a hemolytic disease.
• Fever is common, as is history of a recent febrile illness.
• Usually, no history of heightened jaundice is elicited.
• Abrupt onset in patients with hemolysis; can be life-threatening.

Physical Examination

• Tachycardia
• Pallor
• Systolic (high output) cardiac murmur

Etiology

• Parvovirus B12 is particularly erythrotropic and infects the marrow red cell precursors.

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Jun 19, 2016 | Posted by in PEDIATRICS | Comments Off on Anemia, Aplastic Crisis

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