Aplastic anemia diagnostic study of choice: Difference between revisions
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== Overview == | == Overview == | ||
The [[bone marrow]] biopsy is the gold standard test for the diagnosis of aplastic anemia. A hematopathologist will review the bone marrow biopsy findings, and confirmatory results for aplastic anemia include [[hypoplasia]] with <20% cellularity, normal maturation of all [[cell]] lines, presence of fat cells and [[stroma]] in [[bone marrow]] space. Residual [[hematopoietic cell|hematopoietic cells]] are morphologically normal. [[Hematopoiesis]] is not [[megaloblastic]]. | |||
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== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
=== Study of choice === | === Study of choice === | ||
[[ | The [[bone marrow]] biopsy is the gold standard test for the diagnosis of aplastic anemia<ref name="pmid21495931">{{cite journal |vauthors=Dezern AE, Brodsky RA |title=Clinical management of aplastic anemia |journal=Expert Rev Hematol |volume=4 |issue=2 |pages=221–30 |date=April 2011 |pmid=21495931 |pmc=3138728 |doi=10.1586/ehm.11.11 |url=}}</ref> | ||
===== Diagnostic results ===== | ===== Diagnostic results ===== | ||
The following findings on performing bone marrow biopsy are confirmatory for aplastic anemia: | The following findings on performing bone marrow biopsy are confirmatory for aplastic anemia: | ||
* [[Hypoplasia]] with <20% cellularity | * [[Hypoplasia]] with <20% cellularity | ||
* Normal maturation of all [[cell]] | * Normal maturation of all [[cell]] lines | ||
* | * Presence of adipose cells and [[stroma]] in [[bone marrow]] space | ||
* | * Presence of morphologically normal residual [[hematopoietic cells]] | ||
* [[ | * Absence of [[megaloblastic]] [[hematopoiesis]] | ||
** [[Flow cytometry]] for assessment of cell surface CD59 on peripheral blood red blood cells or [[ | ===== Sequence of diagnostic studies ===== | ||
* '''In adults''' with aplastic anemia, these tests should be done to detect coexistent disorders, such as [[paroxysmal nocturnal hemoglobinuria]], [[myelodysplastic syndrome|myelodysplastic syndrome,]] or [[acute leukemia]]<ref name="pmid12509764">{{cite journal |vauthors=D'Andrea AD, Grompe M |title=The Fanconi anaemia/BRCA pathway |journal=Nat. Rev. Cancer |volume=3 |issue=1 |pages=23–34 |date=January 2003 |pmid=12509764 |doi=10.1038/nrc970 |url=}}</ref>: | |||
** [[Flow cytometry]] for assessment of cell surface CD59 on peripheral blood red blood cells or [[neutrophil|neutrophils]]. | |||
** [[Cytogenetics|Cytogenetic]] and molecular testing of [[bone marrow]] | ** [[Cytogenetics|Cytogenetic]] and molecular testing of [[bone marrow]] | ||
** Hemoglobin electrophoresis and blood-group testing | ** Hemoglobin electrophoresis and blood-group testing | ||
** Serology | ** Serology | ||
** Fluorescence-activated cell sorter (FACS) profiling | ** Fluorescence-activated cell sorter (FACS) profiling | ||
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** Histocompatibility testing | ** Histocompatibility testing | ||
* '''In | * '''In children''' with aplastic anemia, genetic testing should be performed to find out inherited genetic abnormalities. | ||
* | ** [[Fanconi anemia]] | ||
** [[Dyskeratosis congenita]] | |||
** [[Short telomere]] syndromes | |||
==References== | ==References== | ||
Revision as of 00:23, 3 December 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nazia Fuad M.D.
Overview
The bone marrow biopsy is the gold standard test for the diagnosis of aplastic anemia. A hematopathologist will review the bone marrow biopsy findings, and confirmatory results for aplastic anemia include hypoplasia with <20% cellularity, normal maturation of all cell lines, presence of fat cells and stroma in bone marrow space. Residual hematopoietic cells are morphologically normal. Hematopoiesis is not megaloblastic.
Diagnostic Study of Choice
Study of choice
The bone marrow biopsy is the gold standard test for the diagnosis of aplastic anemia[1]
Diagnostic results
The following findings on performing bone marrow biopsy are confirmatory for aplastic anemia:
- Hypoplasia with <20% cellularity
- Normal maturation of all cell lines
- Presence of adipose cells and stroma in bone marrow space
- Presence of morphologically normal residual hematopoietic cells
- Absence of megaloblastic hematopoiesis
Sequence of diagnostic studies
- In adults with aplastic anemia, these tests should be done to detect coexistent disorders, such as paroxysmal nocturnal hemoglobinuria, myelodysplastic syndrome, or acute leukemia[2]:
- Flow cytometry for assessment of cell surface CD59 on peripheral blood red blood cells or neutrophils.
- Cytogenetic and molecular testing of bone marrow
- Hemoglobin electrophoresis and blood-group testing
- Serology
- Fluorescence-activated cell sorter (FACS) profiling
- Fluorescent-labeled inactive toxin aerolysin (FLAER) testing
- Diepoxybutane incubation
- Histocompatibility testing
- In children with aplastic anemia, genetic testing should be performed to find out inherited genetic abnormalities.
References
- ↑ Dezern AE, Brodsky RA (April 2011). "Clinical management of aplastic anemia". Expert Rev Hematol. 4 (2): 221–30. doi:10.1586/ehm.11.11. PMC 3138728. PMID 21495931.
- ↑ D'Andrea AD, Grompe M (January 2003). "The Fanconi anaemia/BRCA pathway". Nat. Rev. Cancer. 3 (1): 23–34. doi:10.1038/nrc970. PMID 12509764.