A case of aplastic anemia complicated with systemic aspergillosis

Abstract

Introduction: Aplastic anemia is a rare disease in which the bone marrow and the hematopoietic stem cells that reside there are damaged. This causes a deficiency of all three blood cell types (pancytopenia). Aplastic refers to the inability of the stem cells to generate mature blood cells. Aplastic anemia can be caused by exposure to certain chemicals, drugs, radiation, infection, immune disease, and heredity; in about half the cases, the cause is unknown. It may also occur due to a congenital inheritance or as well in the context of a constitutional predisposition. Objective: The aim of this paper is to present the case of a 17 years old boy who developed aplastic anemia in the context of using sodium metamizol at home (Algocalmin) for 10 days without medical advice. Due to poor immune system the opportunistic fungus Aspergillus takes advantage of this situation and colonizes throughout the body leading to the condition called Aspersilosis. Clinical case: We monitored the patient for a period of 33 days correspondently to the hospitalization in our Pediatric Clinic I - Hemato-Oncology Department of Targu-Mures. Results: At the admission in our clinic, the first lab tests showed: a marked leukopenia (Leu/mm3- 440, Gran. 7/mm3) and trombocytopenia (PLT/mm3- 26.000) and the peripheral blood smear showed (Segmented 0%, Eo 0%, Ba 0%, Mo 1%, Lymphocytes 99%). The final diagnose was established on the bone marrow biopsy histopathology exam. Than it was performed the Anti Aspergillus fumigatus antibody: 1/320 (NV< 1/80) because of the persisting fever. Immediately it was implemented the antibiotic, antifungal and replacement therapy with a good result. After 33 days of hospitalization the lab tests showed a marked improvement therefore: the leucocytes reached the peak of 5890/mm3,granulocytes 4090/mm3, PLT 384.000/mm3. Conclusions: Due to the fact that the aplastic anemia is secondary to the treatment with Algocalmin occurred in a previously healthy young patient, the bone marrow rehabilitation was achieved with the right treatment. After 6 months after the discharge, the patient had been declared completely cured having both aplastic anemia and systemic aspergillosis extinguished.