[Mike-in-MI]

This is my experience thus far with what we believe to be Aplastic Anemia. I hope the details help someone as I am struggling to help my wife.

In early January, my wife got the flu. It was bad, probably as bad as I have ever seen. Over the course of a weekend (Thursday night to Monday morning) she slept for hours, took NyQuil frequently (did not exceed daily limit) and was completely out of action. By Monday, she was functioning, not great, works from home so well enough to get the kids to school and call in to work meetings. That was easy compared to where we are at now.

Later that month, she developed bruising on her body and still felt fatigued. She went to her primary care doctor and took a blood test, they called the next day. The labs showed dangerous levels, consistent with the LIVER having shut down (example, ALT can run as high as 55, hers was nearly 2,000). She was admitted our local hospital, then transferred to a larger hospital (Henry Ford in Detroit, which has a Liver Clinic) and in total spent 12 days in bed. Eventually she was given a steroid (Prednisone) and Ursodiol/Actigall (protects the Gall Bladder). Numbers came down enough to go home, continue the meds and get blood tests once a week. The doctors suspected acetaminophen poisoning (in NyQuil) at first, but the liver biopsy test never showed dangerous levels. The indicated that it could also be the result of a VIRUS. Basically, we were happy to be on the path to recovery and accepted that we never found a definitive cause.

She had weekly blood work and her liver function numbers steadily improved. One day the doctor calls about the latest blood test saying that her PLATELETE COUNT had DROPPED SUDDENLY (<20 from over200). We went back to the hospital (Note: We went back to the local hospital when we should have gone right to the larger center with more specialists).

They gave her 2 units of platelets, by now she was bruising again. The platelets helped with the bruising, but never permanently raised her count above 30. They then suspected an autoimmune problem, increased her Prednisone levels and gave her IVIG (Intravenous immunoglobulin) with the feeling that this would turn the course in a couple of days. Meanwhile they also took a bone marrow biopsy for analysis.

The IVIG and steroid did not solve the problem, the bone marrow results ruled out leukemia and given her lack of reaction to treatments ruled out ITP. We transferred to University of Michigan Hospital. Their assessment after reviewing what is known is AA. As I am writing this they are getting the biopsy samples to do their own analysis and reach a final conclusion. Likely they will begin ATG+CSA today!