Aplastic crisis
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
- Erythema Infectiosum (Fifth disease)
- Hereditary Spherocytosis (HS)
- Sickle cell crisis
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
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