Factitious aplastic anemia is rare and bizarre.
Patient selection: pancytopenia consistent with aplastic anemia
Risk features:
(1) health care provider with drug access
(2) history of developmental trauma
(3) history of self-injurious behavior
(4) sudden loss or other psychiatric stressor
Clinical features:
(1) severely hypoplastic bone marrow
(2) eventual history of intentional self-exposure to a drug or chemical capable of causing aplastic anemia
(3) exclusion of other causes for aplastic anemia
Busulfan or other alkylating agent is the most often cited, but a person with medical knowledge can choose from a range of drugs and chemicals.
Psychiatric counseling is required. The patient often requires a bone marrow or stem cell transplant.
