A Case Report of Pregnant Woman with Aplastic Anemia: Diagnosis and Management through Subsequent Pregnancy
Journal Title: International Blood Research & Reviews - Year 2015, Vol 3, Issue 2
Abstract
Introduction: Aplastic anemia is characterized by decreased bone marrow function with inadequate production of erythrocytes, granulocytes, and platelets. Marrow failure may be caused by absence of or defects in hematopoietic stem cells, abnormalities of the bone marrow microenvironment, or immune disorders. There are no clear guidelines for the management of aplastic anemia during pregnancy. We report a case of pregnant woman in whom anemia was evaluated and diagnosed as Aplastic anemia, managed through the pregnancy and followed her up until subsequent pregnancy with good outcome. Case: A 19 year teenage girl, primigravida at 36 weeks of gestation presented to our hospital complaining with generalized weakness since 1 month during her antenatal check up. She was evaluated wherein Hb-5.8g/dL, platelet count 11,000, peripheral smear – Megalocytic Anemia with Leucopenia and Thrombocytopenia and no other abnormal cells, was managed conservatively. She had underwent Vaccum assisted vaginal delivery and was third stage of labor was uneventful without any post partum hemorrhage or other bleeding manifestations. During post-partum period, she developed severe anemia and thrombocytopenia with HB-5g/dL, platetlet count of 21,000 and so bone marrow aspiration was done, found to have hypocellular marrow with atypical lymphoid cells, bone marrow biopsy showed hypocellular marrow with decrease in all 3 hematopoietic cell lines, few lymphoid cells with hyper chromatic nucleus and scant eosinophilic cytoplasm, few megakaryocytes. CMV IgM, IgG were found to be positive, ANC was 150 cells /ml and the diagnosis of severe aplastic anemia was confirmed. As her sister was HLA identical sibling, donor stem cell transplantation was performed. She conceived spontaneously, in this subsequent pregnancy had uneventful antenatal, intrapartum and post partum period, delivered live term baby. Conclusion: Women with severe anemia and thrombocytopenia are to be thoroughly evaluated so as to make timely diagnosis of the disease.
Authors and Affiliations
Harshini Vana, J. B. Vidyashree, Mangala Gowri, Renuka Ramaiah
Keywords
Related Articles
- EP ID EP242424
- DOI 10.9734/IBRR/2015/15735
- Views 126
- Downloads 0
Oral Busulfan and Cyclophosphamide (BU/CY) versus Cyclophosphamide, Melphalan and Vepsid (Etoposide) (CMV) with Autologous Stem Cell Transplant in Patients with Relapsed Non-Hodgkin Lymphomas (NHL)
Background: High dose chemotherapy with autologous stem cell transplantation (ASCT) is the standard of care and commonly used procedure for patients with relapsed non Hodgkin lymphomas (NHL). There is no clear evidence o...
Palliative Radiotherapy for Spinal Extramedullary Hematopoiesis in Thalassemia Major
Introduction: Non-hepatosplenic Extramedullary Hematopoiesis (NHEMH) is seen as a compensation mechanism in the patients with hematologic dysfunction. Thalassemia is an autosomal recessive hematologic disorder. The tissu...
Immunological and Hematological Profile of HIV Patients on Anti-retroviral Therapy in Port Harcourt, Rivers State, Nigeria
Aims: To profile CD4 count, TNFα levels and cytopenia in HIV seropositive patients on ART and also evaluate the prevalence of hematological cytopenia. Study Design: The present study is a cross sectional study and was c...
Serum Leptin and Adiponectin Levels in de Novo Acute Myeloid Leukemia Patients: Correlation with Clinical Characteristics
Aim of the Study: Acute myeloid leukemia (AML) is a heterogeneous clonal stem cell malignancy characterized by proliferation of immature hematopoietic cells. Adipokines in particular leptin and adiponectin are highly act...
Progesterone and 17β-Estradiol Levels during Normal Pregnancy and the Puerperium among Women Attending a Tertiary Health Facility Clinic in Jos, Plateau State, Nigeria
Introduction: Progesterone and Estrogen are the chief pregnancy hormones. Their levels increase during pregnancy to aid successful maintenance of pregnancy, which depends on maternal tolerance of the fetal semi allograft...