Upon discussing your symptoms, the doctor will conduct a physical examination and request various blood tests to assess blood cell counts, including red and white blood cells, as well as platelets. Additional tests will be performed to distinguish between aplastic anemia and pure red cell aplasia. Aplastic anemia typically presents with pancytopenia, characterized by low counts of red blood cells, white blood cells, and platelets, whereas pure red cell aplasia involves only a reduction in red blood cell count.
If blood cell counts deviate from normal levels, aplastic anemia may be suspected. Confirmation of the diagnosis typically requires a bone marrow biopsy, which involves extracting a sample from the pelvic bone using a needle. This sample is then analyzed in a laboratory, and a hematologist, a specialist in blood disorders, evaluates the results.
Before performing a bone marrow biopsy, the doctor will order several other tests, including complete blood count, renal function and electrolyte tests, liver enzyme tests, thyroid function tests, and assessments of vitamin B12 and folic acid levels, to gain a comprehensive understanding of the patient’s condition.
Various tests are employed to differentiate between aplastic anemia and pure red cell aplasia, including:
1. Bone marrow aspirate and biopsy to investigate causes of pure red cell aplasia.
2. Review of iatrogenic exposures in the patient’s medical history.
3. Imaging tests such as X-rays, computed tomography (CT) scans, or ultrasound to examine for enlarged lymph nodes (a sign of lymphoma), as well as kidney and bone abnormalities in the arms and hands.
4. Chest X-ray to identify underlying infections.
5. Liver function tests to assess liver health.
6. Viral studies.
7. Measurement of vitamin B12 and folate levels in the blood to detect potential deficiencies.
8. Blood tests for paroxysmal nocturnal hemoglobinuria.
9. Antibody tests to evaluate the competency of the patient’s immune system.