Hematopoietic dysfunction

Introduction Hematopoietic dysfunction refers to a significant reduction in bone marrow hematopoietic tissue due to disease or physical factors, low or partial failure of hematopoietic function, resulting in impaired hematopoiesis, resulting in hematopoietic dysfunction.

Cause

Age, bone marrow aging, certain infections (such as hepatitis virus, parvovirus B19, etc.), application of bone marrow toxic drugs, exposure to toxic chemicals, long-term or excessive exposure to radiation are risk factors for aplastic anemia. In a certain genetic background, aplastic anemia as a heterogeneous "syndrome" may occur through three mechanisms: primary and secondary hematopoietic stem ("seed") defects, hematopoietic microenvironment ("soil"), and immunity ( "Bug" is abnormal. At present, T lymphocyte hyperfunction is considered to play an important role in the pathogenesis of primary acquired aplastic anemia. Aplastic anemia is a T lymphocyte-mediated autoimmune disease with a hematopoietic system as a target organ.

an examination

Related inspection

Bone marrow analysis blood test

(1) Whole blood cell reduction, reticulocyte <0.01, lymphocyte ratio increased.

(2) Platelets <50×10^9/L.

(3) Neutrophils <1.5×10^9/L.

(4) Multi-site hyperplasia of bone marrow (<50% normal) or severely reduced (<25% of normal), hematopoietic cells decreased, the proportion of non-hematopoietic cells increased, bone marrow granules were empty, bone marrow biopsy showed decreased hematopoietic tissue. Bone marrow aspiration and bone marrow biopsy are required tests. Multi-site (different plane) bone marrow hyperplasia decreased, more fat droplets were seen, granules, red and megakaryocytes decreased, lymphocyte and reticular cells, plasma cells increased.

Differential diagnosis

Differential diagnosis

Hypersplenism: hypersplenism (referred to as splenomegaly) is a syndrome, clinical manifestations of splenomegaly, one or more blood cells, and bone marrow hematopoietic cells corresponding hyperplasia, can be relieved by splenectomy. After the treatment of the disease, the clinical symptoms of some cases can be alleviated. After the spleen is removed, the clinical symptoms can be corrected.

Hemoglobinuria: The urine contains free hemoglobin called hemoglobinuria. It is one of the evidences for diagnosing intravascular hemolysis. Because the urine content is not equal to the urine color can be red, rich brown, serious soy sauce color.

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