Red Blood Cells RBCs carry oxygen to all parts of the body. Oxygen is food and nourishment for all the organs, including the heart, lungs, stomach, intestines, and brain, and keeps them working well. Hemoglobin is the protein in the RBCs that attaches to oxygen. Anemia occurs when the blood does not have enough healthy RBCs or hemoglobin. When hemoglobin levels are very low, cells in the body do not get enough oxygen. Platelets Platelets are sticky and help the body control bleeding by clumping together. An example of this is when a cut stops bleeding. As the bleeding slows, the blood cells stick together and form into a clot. If the blood has a low number of platelets, bleeding may be quick and spontaneous (without injury). When platelet levels are very low, a child could bleed into his or her head or another vital part of the body, which can be life threatening. n HOW DID MY CHILD GET APLASTIC ANEMIA? Most cases of aplastic anemia are idiopathic, which means the cause is unknown. We do know that aplas- tic anemia is not caused by anything a parent or child did or did not do. Aplastic anemia has been linked to exposure to radiation and some chemicals, such as benzene. Some inherited diseases, such as Fanconi anemia, dyskeratosis congenita, Shwachman–Diamond syndrome, and Diamond-Blackfan anemia, have been associated with the development of aplastic anemia. Infections such as Epstein Barr virus, hepatitis, and parvovirus (fifth disease) also have been associated with causing aplastic anemia. n WHAT ARE THE SIGNS AND SYMPTOMS OF APLASTIC ANEMIA? Signs and symptoms of aplastic anemia occur as a result of bone marrow failure. If your child’s WBC count is low, he or she is at risk for developing fever and infection. It is important to monitor your child closely for fever and to contact your healthcare team immediately if a fever develops. If your child’s RBC count is low, he or she may become pale, suffer from fatigue (decreased energy), and experience shortness of breath or headaches. If your child’s hemoglobin level becomes extremely low, he or she may receive a packed RBC transfusion. If your child’s platelet count is low, he or she is at risk for bleeding and can have spontaneous nosebleeds, bleeding gums, excessive bruising, bruising in unusual areas such as the back or chest, and petechiae (pinpoint purple dots on the skin that are small hemorrhages). If your child’s platelet count is very low and he or she is experiencing bleeding, a platelet transfusion may be given.
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