What Are the Signs and Symptoms of Aplastic Anemia?

Low numbers of red blood cells, white blood cells, and platelets cause most of the signs and symptoms of aplastic anemia.

Signs and Symptoms of Low Blood Cell Counts

Red Blood Cells

The most common symptom of a low red blood cell count is fatigue (feeling tired or weak). Not having enough hemoglobin in the blood causes fatigue. Hemoglobin is an iron-rich protein in red blood cells that carries oxygen to the body.

A low red blood cell count also can cause shortness of breath; dizziness, especially when standing up; headache; coldness in your hands or feet; pale skin, gums, and nail beds; and chest pain.

If you don't have enough hemoglobin-carrying red blood cells, your heart has to work harder to circulate the reduced amount of oxygen in your blood. This can lead to arrhythmias, heart murmur, an enlarged heart, or even heart failure.

White Blood Cells

White blood cells help fight infections. Signs and symptoms of a low white blood cell count include fevers, frequent infections that can be severe, and flu-like illnesses that linger.

Platelets

Platelets stick together to seal small cuts on blood vessel walls and stop bleeding. People who have low platelet counts tend to bruise and bleed easily, and the bleeding may be hard to stop.

Common types of bleeding linked to a low platelet count include nosebleeds, bleeding gums, pinpoint red bleeding spots on the skin, and blood in the stool. Women also may have heavy menstrual bleeding.

Other Signs and Symptoms

Aplastic anemia can cause signs and symptoms that aren't directly related to low blood cell counts. Examples include nausea (feeling sick to your stomach) and skin rashes.

Paroxysmal Nocturnal Hemoglobinuria

About one-third of people who have aplastic anemia have a condition called paroxysmal nocturnal hemoglobinuria (PNH). This is a red blood cell disorder. Most people who have PNH don't have any signs or symptoms.

If symptoms do occur, they may include:

• Shortness of breath
• Swelling or pain in the abdomen or swelling in the legs caused by blood clots
• Blood in the urine
• Headache
• Jaundice (a yellowish color of the eyes or skin)

In people who have aplastic anemia with PNH, either condition can develop first.