Which of the following diagnostic findings are most likely for a client with aplastic anemia?
A. Decreased production of T-helper cells.
B. Decreased levels of white blood cells, red blood cells, and platelets.
C. Increased levels of WBCs, RBCs, and platelets.
D. Reed-Sternberg cells and lymph node enlargement.
Correct Answer: B. Decreased levels of white blood cells, red blood cells, and platelets
In aplastic anemia, the most likely diagnostic findings are decreased levels of all the cellular elements of the blood (pancytopenia). The moderate disease has less than 30% bone marrow cellularity; the severe disease has less than 25% cellularity or less than 50% cellularity containing fewer than 30% hematopoietic cells, and very severe meets severe criteria plus neutropenia less than 200/µL.
Option A: T-helper cell production doesn’t decrease in aplastic anemia. Partial T-cell defects commonly cause abnormalities of immune regulation. Thus, T-cell to B-cell communication is defective, with partial defects in antibody production and increased incidence of atopy and autoimmune disorders.
Option C: The diagnostic criteria for aplastic anemia are the following: the presence of bone marrow hypocellularity and 2 or more cytopenias (reticulopodia less than 1% or less than 40,000/microliter, neutropenia less than 500/microliter, or thrombocytopenia less than 20,000/microliter).
Option D: Reed-Sternberg cells and lymph node enlargement occur with Hodgkin’s disease. Hodgkin lymphoma characteristically presents with Hodgkin and Reed-Sternberg cells. When the cells are mononucleated, they are called Hodgkin cells. When they are multinucleated, they are called Reed-Sternberg cells. The classic Reed-Sternberg cell is a large cell that can be more than 50 micrometers in diameter.
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