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Aplastic anemia and Lupus

Friday, 8 June 2012

Q. "Is Aplastic anemia linked to Lupus ?"

Ans. Yes, both diseases are auto-immune disorders (which means that they occur because the immune system decides to attack the healthy body cells). Auto-immune diseases are caused by defective genes which can run in families. So it is normal to find that these diseases are affecting more than one in a single family.
In fact, aplastic anemia is a rare but serious complication of systemic lupus erythematosus. Aplastic anemia may pass unnoticed in many lupus patients because lupus itself may cause peripheral destruction of formed blood cells. So any lupus patient suffering from severe pancytopenia (decreased red blood cells, decreased white blood cells and decreased platelets) should get checked to exclude the presence of aplastic anemia.

What is aplastic anemia ?
It is when the bone marrow fails or is suppressed to form all blood cells including red blood cells, white blood cells and platelets. People with aplastic anemia will suffer because of the deficiency of each of these blood elements in the form of:
- Skin pallor, fatique, palpitations (due to low RBC's).
- Fever and infections (due to low WBC's).
- Hemorrhage and bleeding tendency (due to low platelets).

Aplastic anemia has many causes:
- Automimmune: due to mutations in TERT gene.
- Chemotherapy and radiation.
- Toxic exposure to benzene and pesticides.
- Infections: hepatitis C, HIV, EBV, parvovirus B19.
- Drugs as cimetidine, busulfan, chloramphenicol, sulfonamides, phenylbutazone.
- Idiopathic (no known cause) - which is the commonest cause.

Lupus is a chronic and distressing auto-immune disease linked lately to a mutation in TREX 1 gene.

Last but not least, i hope gene therapy will find a final cure to these disorders.    

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