Aplastic anemia is a disease in which the body fails to produce blood cells in sufficient numbers. Blood cells are produced in the bone marrow by stem cells that reside there. Aplastic anemia causes a deficiency of all blood cell types: red blood cells, white blood cells, and platelets.It occurs most frequently in people in their teens and twenties but is also common among the elderly. It can be caused by heredity, immune disease, or exposure to chemicals, drugs, or radiation. However, in about half of cases, the cause is unknown.Aplastic anemia can be definitively diagnosed by bone marrow biopsy. Normal bone marrow has 30–70% blood stem cells, but in aplastic anemia, these cells are mostly gone and are replaced by fat.First-line treatment for aplastic anemia consists of immunosuppressive drugs—typically either anti-lymphocyte globulin or anti-thymocyte globulin—combined with corticosteroids, chemotherapy, and ciclosporin. Hematopoietic stem cell transplantation is also used, especially for patients under 30 years of age with a related, matched marrow donor.Aplastic anemia is known to have caused the deaths of Eleanor Roosevelt and Marie Curie. Signs and symptoms
Anemia may lead to fatigue, pale skin, severe bruising, and a fast heart rate.Low platelets are associated with an increased risk of bleeding, bruising, and petechiae, with lower blood counts that impact the ability of the blood to clot. Low white blood cells increase the risk of infections. Causes
Aplastic anemia can be caused by immune disease or exposure to certain chemicals, drugs, radiation, or infection; in about half the cases, a definitive cause is unknown.
Insulin lispro, sold under the brand name Humalog among others, is a modified type of medical insulin used to treat type 1 and type 2 diabetes. Typically it is taken around the time of eating. It is used by injection under the skin or within an insulin pump. Onset of effects typically occurs within 30 minutes and lasts about 5 hours. Often a longer-acting insulin like insulin NPH is also needed.Common side effects include low blood sugar. Other serious side effects may include low blood potassium. Use in pregnancy and breastfeeding is generally safe. It works the same as human insulin by increasing the amount of glucose that tissues take in and decreasing the amount of glucose made by the liver.Insulin lispro was first approved for use in the United States in 1996. It is a manufactured form of human insulin where an amino acid has been switched. In 2019, it was the 65th most commonly prescribed medication in the United States, with more than 11 million prescriptions. Medical uses
Insulin lispro is used to treat people with type 1 diabetes or type 2 diabetes. People doing well on regular insulin should not generally be changed to insulin lispro. Side effects
Common side effects include skin irritation at the site of injection, hypoglycemia, hypokalemia, and lipodystrophy. Other serious side effects include anaphylaxis, and hypersensitivity reactions. Contraindications
Do not administer insulin lispro during episodes of hypoglycemia, or if a person has a hypersensitivity to insulin lispro or any of its excipients.