Retinal Microaneurysms in a Patient with Drug-Induced Aplastic Anemia

Objective. Drugs can induce almost the entire spectrum of hematologic disorders, affecting white cells, red cells, platelets, and the coagulation system. This paper aims to emphasize the broad range of drug-induced hematological syndromes and to highlight some of the newer drugs and syndromes.Methods. Medline literature on drug-induced hematologic syndromes was reviewed. Most reports and reviews focus on individual drugs or cytopenias.Results. Drug-induced syndromes include hemolytic anemias, methemoglobinemia, red cell aplasia, sideroblastic anemia, megaloblastic anemia, polycythemia, aplastic anemia, leukocytosis, neutropenia, eosinophilia, immune thrombocytopenia, microangiopathic syndromes, hypercoagulability, hypoprothrombinemia, circulating anticoagulants, myelodysplasia, and acute leukemia. Some of the classic drugs known to cause hematologic abnormalities have been replaced by newer drugs, including biologics, accompanied by their own syndromes and unintended side effects.Conclusions. Drugs can induce toxicities spanning many hematologic syndromes, mediated by a variety of mechanisms. Physicians need to be alert to the potential for iatrogenic drug-induced hematologic complications.

Download Full-text

A Study of Aplastic Anemia in an Autopsy Series With Special Reference to Atomic Bomb Survivors in Hiroshima and Nagasaki

Blood ◽

10.1182/blood.v38.1.17.17 ◽

1971 ◽

Vol 38 (1) ◽

pp. 17-26 ◽

Cited By ~ 6

Author(s):

JACK D. KIRSHBAUM ◽

TAKESHI MATSUO ◽

KAZUO SATO ◽

MICHITO ICHIMARU ◽

TAISO TSUCHIMOTO ◽

...

Keyword(s):

Bone Marrow ◽

Ionizing Radiation ◽

Aplastic Anemia ◽

Late Effects ◽

Atomic Bomb ◽

Drug Induced ◽

Atomic Bomb Survivors ◽

Autopsy Series ◽

Delayed Complication ◽

The Subject

Abstract A study of the occurrence of aplastic anemia among atomic bomb survivors in Nagasaki and Hiroshima, Japan was made from a review of a series of 6327 autopsies from 1949 to June 1967 and the late effects of ionizing radiation were evaluated. There were 340 cases reviewed independently by a team of hematologists and pathologists. Of the 45 cases documented as aplastic anemia, 42 were definite and three were probable. Six additional cases were classified as probable. The cases were grouped into four categories depending upon the distance of the subject from the hypocenter at the time of the bomb (ATB). All patients fulfilled the requirement clinically of having pancytopenia. Bone marrow findings at autopsy from various sites revealed aplastic or hypocellular changes in 77.3%. The etiology in 42 cases was idiopathic, one case was drug-induced, one case received radiation for carcinoma of the cervix, and one case congenital in origin. No difference was noted in the exposed cases from the nonexposed. Of those who were exposed to 10 or more rad, the majority (four of five) died prior to 1955. On the basis of the data presented, there is no definite morphologic evidence that implicates ionizing radiation in the pathogenesis of aplastic anemia as a delayed complication of exposure in the A-bomb survivors.

Download Full-text

Drug-induced leukopenia and aplastic anemia

Clinical Pharmacology & Therapeutics ◽

10.1002/cpt197112113 ◽

1971 ◽

Vol 12 (1) ◽

pp. 13-43 ◽

Cited By ~ 49

Author(s):

Anthony V. Pisciotta

Keyword(s):

Aplastic Anemia ◽

Drug Induced

Download Full-text

Alteration in Marrow Stromal Microenvironment and Apoptosis Mechanisms Involved in Aplastic Anemia: An Animal Model to Study the Possible Disease Pathology

Stem Cells International ◽

10.4061/2010/932354 ◽

2010 ◽

Vol 2010 ◽

pp. 1-12 ◽

Cited By ~ 17

Author(s):

Sumanta Chatterjee ◽

Ranjan Kumar Dutta ◽

Pratima Basak ◽

Prosun Das ◽

Madhurima Das ◽

...

Keyword(s):

Animal Model ◽

Stem Cell ◽

Aplastic Anemia ◽

Cellular Proliferation ◽

Bone Marrow Failure ◽

Hematopoietic Progenitor Cell ◽

Drug Induced ◽

Bone Marrow Failure Syndrome ◽

Stromal Microenvironment ◽

Underlying Mechanisms

Aplastic anemia (AA) is a heterogeneous disorder of bone marrow failure syndrome. Suggested mechanisms include a primary stem cell deficiency or defect, a secondary stem cell defect due to abnormal regulation between cell death and differentiation, or a deficient microenvironment. In this study, we have tried to investigate the alterations in hematopoietic microenvironment and underlying mechanisms involved in such alterations in an animal model of drug induced AA. We presented the results of studying long term marrow culture, marrow ultra-structure, marrow adherent and hematopoietic progenitor cell colony formation, flowcytometric analysis of marrow stem and stromal progenitor populations and apoptosis mechanism involved in aplastic anemia. The AA marrow showed impairment in cellular proliferation and maturation and failed to generate a functional stromal microenvironment even after 19 days of culture. Ultra-structural analysis showed a degenerated and deformed marrow cellular association in AA. Colony forming units (CFUs) were also severely reduced in AA. Significantly decreased marrow stem and stromal progenitor population with subsequently increased expression levels of both the extracellular and intracellular apoptosis inducer markers in the AA marrow cells essentially pointed towards the defective hematopoiesis; moreover, a deficient and apoptotic microenvironment and the microenvironmental components might have played the important role in the possible pathogenesis of AA.

Download Full-text

Drug-Induced Aplastic Anemia-A Forensic Overview and Review of Literature

Journal of Indian Academy of Forensic Medicine ◽

10.5958/0974-0848.2018.00022.2 ◽

2018 ◽

Vol 40 (1) ◽

pp. 122

Author(s):

Gerard Pradeep Devnath ◽

Siddhartha Das ◽

Rakhee Kar ◽

Rajesh Nachiappa Ganesh

Keyword(s):

Aplastic Anemia ◽

Review Of Literature ◽

Drug Induced

Download Full-text