Aplastic anemia following high-voltage electrical injury: A case report

High-voltage electrical injuries (HVEI) can lead to a wide range of complications, including musculoskeletal, neurological, cardiac, and renal damage. Hematological complications are rare but have been reported, with aplastic anemia being an exceptionally uncommon consequence. To date, only two cases of aplastic anemia following HVEI have been documented.

We report the case of a 21-year-old male who sustained a HVEI and developed progressive pancytopenia during hospitalization. Despite stable vital signs and initially normal lab results, his hemoglobin dropped significantly by day 17, followed by a marked decline in white blood cell and platelet counts. Bone marrow biopsy confirmed the diagnosis of aplastic anemia. The patient had no prior hematological conditions or evidence of infection, and his medications were not known to cause bone marrow suppression. He was treated with supportive care, G-CSF, corticosteroids, and Danazol. After several weeks, his blood counts gradually recovered, and full remission was confirmed one month post-discharge.

This case highlights the potential for bone marrow suppression and aplastic anemia following HVEI, even in the absence of infection or drug-induced toxicity. The delayed onset of pancytopenia suggests a need for ongoing hematological monitoring in similar patients. This case contributes to the limited literature on this rare complication and emphasizes the importance of early recognition and management.

Aplastic anemia is a rare but serious complication of HVEI. Clinicians should maintain a high index of suspicion for hematological abnormalities in burn patients, particularly in the weeks following injury. Early diagnosis and treatment are essential for favorable outcomes.