Aplastic Crisis

What is aplastic crisis?

An aplastic crisis happens when your bone marrow suddenly stops making red blood cells. Aplastic crises can be life-threatening because they cause severe anemia. Aplastic crises typically affect people with sickle cell anemia and similar blood disorders. A common viral infection, parvovirus B19, triggers aplastic crises. Aplastic crises typically affect more children than adults. Healthcare providers treat aplastic crises with blood transfusions and intravenous immunoglobulin (IVIG).

Is this a common condition?

No. While parvovirus B19 is a common virus, an aplastic crisis only happens to people with certain blood disorders who also have parvovirus B19 infections. Aplastic crises typically affect newborns, babies and children with sickle cell anemia. But people with conditions that destroy red blood cells and cause hemolytic anemia also have an increased risk of an aplastic crisis if they have parvovirus B19. Those conditions include:

• Hereditary spherocytosis.
• Hemoglobin C disease.
• Thalassemia.
• GRPD deficiency syndrome.
• Pyruvate kinase.
• Autoimmune hemolytic anemia.
• Paroxysmal nocturnal hemoglobinuria.
• Hereditary elliptocytosis.

What are aplastic crisis symptoms?

Adults, children and babies with aplastic crisis typically have symptoms associated with severe anemia. Babies and young children may be more fussy or irritable than usual. Aplastic crisis symptoms include:

• Fatigue (extreme tiredness).
• Fever (temperature of 101 degrees Fahrenheit, or 38 degrees Celsius).
• Dizziness.
• Shortness of breath (dyspnea).
• Irregular or rapid heartbeat.
• Pallor(or lips, gums or fingernails that are paler than usual).

What causes aplastic crisis?

“Aplastic” means something in your body has stopped working. In an aplastic crisis, your bone marrow can’t produce healthy red blood cells because parvovirus B19 targets and damages immature red blood cells. Your body relies on your bone marrow for red blood cells, some white blood cells and plasma. Without a steady flow of red blood cells, you develop severe anemia.

What are the complications of this condition?

Aplastic crisis may cause the following complications for people with sickle cell anemia:

• Prolonged vaso-occlusive crisis (VOC): VOC is a sudden onset of intense pain. VOC affects people with sickle cell anemia.
• Myocarditis: This is inflammation of your heart muscle.
• Splenetic sequestration: Abnormal red blood cells get stuck in your spleen, causing your spleen to get larger.
• Glomerulonephritis: Kidney disease that may lead to kidney failure.

How do healthcare providers diagnose aplastic crisis?

Healthcare providers will ask about symptoms and do a physical examination. They may do the following tests:

• Complete blood count (CBC).
• Reticulocyte count.
• Parvovirus B19 test.

How do healthcare providers treat aplastic crisis?

Providers treat this condition with blood transfusions and immunoglobulin delivered through an intravenous (IV) tube. Most people recover from aplastic crises within 10 to 14 days of starting treatment. Once they have parvovirus B19, they have lifetime immunity, which reduces the risk of additional aplastic crises.

Can people prevent aplastic crisis?

That’s hard to say. Aplastic crisis happens when people with certain blood disorders have parvovirus B19 infections. Parvovirus B19 is very common and there’s no vaccine that protects against it. If you or your child has sickle cell anemia or a similar blood disorder, ask your healthcare provider about steps you could take to reduce the risk of parvovirus B19 infection.

What’s the prognosis for aplastic crisis?

Prognosis is your expected outcome given your situation. People with aplastic crisis usually recover within 10 to 14 days after starting treatment. But some people may have recurring aplastic crises, or crises that keep on happening.

How do I take care of myself?

Aplastic crisis is one of several potential complications of sickle cell anemia and similar blood disorders. Although you may not prevent parvovirus B19, there are steps you can take to support your overall health:

• Get regular checkups. Regular health checkups with your primary provider care may head off serious medical complications.
• Lower your risk of infections. Talk to your healthcare provider about ways to protect yourself from common infections such as flu (influenza) or colds.
• Eat a healthy diet. Eat a balanced diet and drink eight to 10 glasses of water every day.
• Get some exercise. Regular physical activity boosts your mood and health. But be sure to take it easy, rest when you need to and stay hydrated.

When should I see my healthcare provider?

Aplastic crisis is a medical emergency. If you have sickle cell anemia or a similar blood disorder, contact your healthcare provider right away if you notice sudden changes in your body such as suddenly feeling weak or feeling extremely tired.

What questions should I ask my healthcare provider?

If you or your child experience aplastic crisis, you may want to ask the following questions:

• When will I/my child start to feel better?
• What are the chances I/my child will have another aplastic crisis?

Is aplastic crisis the same as aplastic anemia?

Both conditions involve low red blood cell counts. But aplastic crisis is a sudden drop in red blood cell count, while aplastic anemia develops over time, as all of your blood cell levels can decline.

A note from Cleveland Clinic

An aplastic crisis is one of several serious complications that affect people with sickle cell anemia and similar blood disorders. In an aplastic crisis, your or your child’s bone marrow suddenly stops making red blood cells and you may develop severe anemia that can be life-threatening. Aplastic crises may be scary because symptoms may be sudden and severe. Fortunately, healthcare providers can treat an aplastic crisis with blood transfusions and medications. If you or your child have blood disorders that increase the risk of aplastic crisis, ask your healthcare provider what symptoms are signs of trouble. You may not be able to prevent an aplastic crisis, but you’ll know what to do if it happens.