Marked reduction in all three cell lines (erythroid, myeloid, and megakaryocytic-), with replacement by normal fat, characterize the classic picture of aplastic anemia. Aplastic anemia results from defect or damage to the pleuripotent stem cells. In children, about a third of cases are hereditary, most commonly Fanconi anemia. In adults, most acquired aplastic anemia results as a planned or idiosyncratic reaction to medications. Several hundred toxic agents have been linked as well (e.g. benzene). Hepatitis C and end stage renal failure also may cause aplastic anemia. A bone marrow biopsy is indispensible for diagnosis.
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