If you have aplastic anemia, you may have the following symptoms:

• shortness of breath and fatigue, which is caused by anemia (too few red blood cells)
• serious infections because of not enough infection-fighting white blood cells (neutropenia/leukopenia)
• abnormal bruising or bleeding because of a shortage of platelets (thrombocytopenia)

Some people may not have any symptoms, but results of a routine blood test may suggest a diagnosis of aplastic anemia. There are other conditions in which blood formation may be abnormal. Your doctor will consider all of these when determining your diagnosis.

Tests to diagnose aplastic anemia

Two tests are used to diagnose aplastic anemia.

• complete blood count (commonly called a CBC). In aplastic anemia this test will show that the red cell count, white cell count, and platelet count are low.

• bone marrow biopsy. This test looks at the bone marrow.

Bone marrow biopsy

A bone marrow biopsy has 2 parts -- the aspiration and the biopsy. This procedure is usually done with you lying on your stomach. A part of the pelvic bone about 2 inches to the side of the spine and the skin above it are numbed with local anesthetic. A tiny cut (about 1/8 inch) may be made in the skin to make it easier to insert the needle.. Then, for the aspiration, a large needle is placed through the incision into the bone. A syringe is used to remove a small amount of liquid bone marrow (about 1 teaspoon).

For the biopsy, a small cylinder-shaped piece of bone and marrow (about 1/16 inch in diameter and 1/3 inch long) is removed with the needle. Both samples usually are taken during the same procedure from the same place in the back of the pelvic (hip) bone. In spite of anesthesia, this procedure may still be uncomfortable, particularly when the marrow is sucked out.

Usually a pathologist, a doctor specializing in diagnosing disease by lab tests, examines the bone marrow under a microscope. A hematologist (internist who specializes in blood diseases) or a hematopathologist (a pathologist who specializes in blood diseases) could also look at the bone marrow sample. Normally, the bone marrow contains many cells that produce the different types of blood cells. Finding an "empty" bone marrow, that is, one that lacks normal blood-producing cells, confirms the diagnosis of aplastic anemia. Leukemia or other kinds of cancers can also cause low blood counts, but in that case the bone marrow would be filled with leukemia cells or other cancer cells.

Last Medical Review: 06/17/2009
Last Revised: 06/17/2009