Aplastic Anemias. The aplastic anemias may follow poisoning with benzol, arseni cals, gold or radiant energy (x-ray or radium). Idiopathic aplastic anemia may develop rapidly without known cause. There is a characteristic triad in these cases, consisting of progressively severe anemia, thrombocytopenia and leukopenia. The absence of a palpable spleen helps to distinguish this condition from aleukemic leukemia. The red corpuscles are normal in appearance. Nucleated and stippled forms and other signs of regeneration are absent. The bone marrow is hypoplastic. The white count usually shows 70 to 90 per cent lymphocytes. Repeated transfusions are usually the only remedy.
Repressive Anemia. This anemia is the simple chronic type, and occurs sympto matically in chronic infections, renal disease, malignancy, endocrine disorders, pregnancy and vitamin deficiencies other than B 12. Erythropoiesis is inhibited by circulatory toxins or other causes. The red cell count rarely Calls below 3.5 million. The number of cells, their size and the quantity of hemoglobin are proportionately decreased, so that the anemia is normocytic. Evidence of regeneration or increased blood destruction is usually absent.
Repressive Anemia. This anemia is the simple chronic type, and occurs sympto matically in chronic infections, renal disease, malignancy, endocrine disorders, pregnancy and vitamin deficiencies other than B 12. Erythropoiesis is inhibited by circulatory toxins or other causes. The red cell count rarely Calls below 3.5 million. The number of cells, their size and the quantity of hemoglobin are proportionately decreased, so that the anemia is normocytic. Evidence of regeneration or increased blood destruction is usually absent.
Myelophthisic Anemias. This form of anemia is produced by replacement of the marrow by nonfunctioning elements. Metastatic carcinoma to bone, multiple myeloma, myelosclerosis and lipoid storage diseases affecting bones are etilogic factors. Pain referred to the skeleton and splenomegaly are often present. The anemia is variable in degree and most often normo cytic. Primitive red blood cells or leukocytes may be found in the peripheral circulation, together with reticulocytes and stippled cells. Roentgenography of the skeleton aids in diagnosis. Treatment must be directed to the underlying condition.
