What Is Red Cell Aplasia?

Red cell aplasia is a bone marrow disorder where precursors to red blood cells decline, leading to an overall drop in red blood cell production. Other blood components like white blood cells are present in normal concentrations with this condition. The patient develops acute anemia as a result of the red blood cell deficiency, and can become very ill without treatment. Care can involve doctors from a number of specialties, as the causes of this condition can be varied.

In red cell aplasia, the bone marrow cannot make enough red blood cells, and the patient starts to develop fatigue, pallor, and other symptoms of anemia. A blood test will reveal an abnormally low count of red cells and may provide some other clues into the condition, like signs of a viral infection or hormone disruption that could explain why the bone marrow isn't producing the right kinds of cells in the necessary quantities. Other cells will appear physically normal under the microscope.

Sometimes the cause of red cell aplasia is not clear. In others, it can be an autoimmune condition, where a problem with the immune system interferes with the production of new red blood cells. Medication reactions can also cause it, as can tumors on the thymus gland and viral infections. A doctor who notices signs of red cell aplasia can order some tests to collect more information about the cause, such as white blood cell counts to look for higher numbers associated with infections, or medical imaging studies of the thymus to spot a tumor.

Available treatments depend on why the patient is ill. Some patients benefit from steroid medications to suppress the immune system, and will experience a return of red blood cells while on these medications. There can be risks to this treatment approach, as any latent infection will recur while on steroids because of the weakened immune system. Patients may also react badly to the medications, and will be at increased risk of infections as long as they take the steroids, which can make them a poor long-term method for managing the condition.

If an underlying problem causes the red cell aplasia, treating that should allow red blood cell counts to return to normal. This could include antiviral medications for infections, surgery for tumors, and supportive care to help the patient recover. The doctor will order periodic blood work to see if the patient's bone marrow is responding to the treatment with an increase in red blood cell production.