Which medication is classically associated with aplastic anemia?

• A. Chloramphenicol
• B. Acetazolamide
• C. Isotretinoin
• D. Prostaglandins

Answer: (A)

Aplastic anemia arises from a severe failure of the bone marrow to produce blood cells, and chloramphenicol is a well-known classic cause of this condition. The risk is idiosyncratic and can occur at any dose, with the marrow becoming hypocellular and pancytopenic. Even after stopping the drug, the damage can be irreversible and life-threatening, which is why this medication is infamous for this adverse effect. Clinically, patients may present with fatigue, infections, easy bruising, and bleeding due to low red cells, white cells, and platelets.

The other drugs listed do not have a classic association with aplastic anemia. Acetazolamide mainly causes metabolic and electrolyte disturbances; isotretinoin is primarily linked to teratogenicity and hepatotoxicity; prostaglandins can have cardiovascular and other systemic effects but are not classically tied to bone marrow suppression.