Differential Diagnosis of Aplastic Anemia

In this article, we will discuss Differential Diagnosis of Aplastic Anemia. So, let’s get started.

Differential Diagnosis

Aplastic anemia should be differentiated from other conditions producing pancytopenia such as:

1. Subleukemic or aleukemic leukemia

2. Myelodysplastic syndrome

3. Hypersplenism (e.g. portal hypertension, infiltrative splenomegaly)

4. Bone marrow infiltration (carcinoma, myelofibrosis)

5. Megaloblastic anemia

6. Osteoporosis (marble bone disease)

7. Systemic lupus erythematosus

8. Paroxysmal nocturnal hemoglobinuria

9. Disseminated tuberculosis

10. Overwhelming infection

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Pathogenesis of Thrombotic Thrombocytopenic Purpura

In this article, we will discuss the Pathogenesis of Thrombotic Thrombocytopenic Purpura. So, let’s get started.

Pathogenesis

The pathogenesis of thrombotic thrombocytopenic purpura (idiopathic or inherited) is related to deficiency of, or antibodies to, a metalloprotease that cleaves vWF and ADAMTS 13 respectively. Non-cleavage of large vWF molecules results in their persistence which leads to platelet aggregation and adhesion. The manifestations are as a result of localized platelet thrombi and fibrin deposition in microvasculature. Arterioles are filled with hyaline material (fibrin and platelets) and similar material may also be seen beneath the endothelium of the involved vessels. Immunofluorescence studies have shown deposition of immunoglobulins and complement in arterioles indicating an immunologic origin. Microaneurysm of arterioles may also be seen.