Thrombocytopenia: Symptoms and Treatment
The disease that causes a decrease in the number of platelets in the blood is called thrombocytopenia. It is about him that the article itself will tell. Platelets are small blood cells that do not have color and are significant components that participate in blood clotting. The disease is serious enough, as the disease can lead to hemorrhage in the internal organs (especially in the brain), and this is a deadly end.
Like most medical diseases, thrombocytopenia has its own classification, which is formed on the basis of pathogenetic factors, causes, symptoms and various manifestations.
According to the criterion of etiology, there are two types of disease:
They are characterized by the fact that the primary type manifests itself as an independent disease, and the secondary type is provoked by a number of other diseases or pathological abnormalities.
The duration of the disease in the human body is divided malaise of two types: acute and chronic . Acute — is characterized by short-term effects on the body (up to six months), but manifested instantaneous symptoms. The chronic appearance is characterized by a prolonged decrease in platelets in the blood (over half a year). It is the chronic appearance that is more dangerous, since the treatment takes up to two years.
According to the criteria for the severity of the disease, characterized by a quantitative composition of platelets in the blood, three degrees are distinguished:
- I — composition is 150-50х10 9 sup> / л — the criterion of gravity is satisfactory
- II — 50-20х10 9 sup> / л — reduced composition, which is manifested with minor damage to the skin
- III — 20х10 9 sup> / л — is characterized by the appearance of internal bleeding in the body.
The norm of blood cells in the body is from 140 000 to 440 000 / μl. But it is in the female body that these indicators are constantly changing. Changes are influenced by such factors:
- Complications after pregnancy.
Platelets appear in the body from the bone marrow, which by stimulation of megakaryocytes synthesizes blood cells. The synthesized blood plates circulate through the blood for seven days, after which the process of their stimulation is repeated.
According to the International Classification of Diseases of the tenth convocation (ICD-10), this ailment has its codes:
- D50-D89 — diseases of the circulatory system and other types of insufficiency
- D65-D69 — blood clotting disorders
Often the cause of the disease is the allergic reaction of the body to various medications as a result of which there is observed drug thrombocytopenia. With this indisposition, the body develops antibodies directed against the drug. To drugs that affect the appearance of circulatory insufficiency of corpuscles, include sedative, alkaloid and antibacterial agents.
Causes of insufficiency may be problems with immunity caused by the consequences of blood transfusions.
Especially often the disease manifests itself when the blood groups do not coincide. Most often observed in the human body is autoimmune thrombocytopenia. In this case, immunity is incapable of recognizing its platelets and tearing them from the body. As a result of rejection, antibodies are produced to remove foreign cells. The reasons for this thrombocytopenia are:
- Pathological kidney failure and chronic hepatitis
- Lupus, dermatomyositis and scleroderma
- Leukemia diseases.
If the disease has a pronounced form of an isolated disease, then it is called idiopathic thrombocytopenia or Verlhof disease (ICD-10 code: D69.3). The etiology of idiopathic thrombocytopenic purpura (ICD-10: D63.6) remains unclear, but medical scientists are inclined to believe that this is due to a hereditary predisposition.
It is also characteristic manifestation of the disease in the presence of congenital immunodeficiency. Such people are most susceptible to the factors of the onset of the disease, and the reasons for this are:
- damage to red bone marrow from exposure to drugs
- Immunodeficiency causes megakaryocyte damage.
There is a productive nature of the disease, which is caused by insufficient production of platelets by the bone marrow. In this case, their insufficiency arises, and as a result, flowing into an ailment. The causes are myelosclerosis, metastases, anemia, etc.
Lack of platelets in the body is observed in people with a reduced composition of vitamin B12 and folic acid. Excessive radioactive or radiation exposure is also not excluded for the appearance of insufficiency of blood cells.
Thus, we can distinguish two types of causes that affect the occurrence of thrombocytopenia:
- Disruptive blood cells: idiopathic thrombocytopenic purpura, autoimmune abnormalities, surgical interventions on the heart, clinical impairment of blood circulation in pregnant women, and side effects of drugs
- Reducing bone marrow production of antibodies: viral influences, metastatic manifestations, chemotherapy and radiation exposure, and excessive drinking
Symptoms of thrombocytopenia have different manifestations. It depends:
- First, from the cause of the occurrence;
- Secondly, on the nature of the course of the disease (chronic or acute).
The main signs of damage to the body are manifestations of the skin in the form of hemorrhages and bleeding. There are hemorrhages most often on the limbs and trunk. Damage to the face and lips of a person is not excluded. For clarity of manifestations of hemorrhages on the human body, the photo below is presented.
Thrombocytopenia is characterized by symptoms of prolonged hemorrhage after tooth extraction. And the duration of hemorrhage can be either one-day or accompanied for several days. It depends on the degree of the disease.
With symptomatology, there is no increase in liver size, but very often doctors observe an expansion of the cervical lymph nodes. This phenomenon is often accompanied by an increase in body temperature to subfebrile values (from 37.1 to 38 degrees). The increase in the rate of occurrence of erythrocytes in the body is evidence of the presence of a malaise called lupus erythematosus.
Symptomatic of platelet deficiency is quite easy after taking blood for analysis. The quantitative composition will differ significantly from the marginal standards. With a decrease in the number of platelets in the blood, their size increases. On the skin, this is reflected in the appearance of red and bluish spots, which indicates the transformation of blood cells. There is also destruction of red blood cells, which leads to a decrease in the quantitative composition, but the number of reticulocytes increases. There is a phenomenon of shifting the leukocyte formula to the left.
The human body with a reduced composition of blood cells is characterized by an increase in the composition of megakaryocytes, which is caused by frequent and extensive bleeding. The duration of blood clotting is markedly increased, and the reduction in the concentration of blood emerging from the wound is reduced.
According to the symptoms of the manifestation of the disease, three degrees of complication are distinguished: mild, moderate and severe.
An easy cause is the cause of the disease in women with prolonged and profuse menstruation, as well as with intradermal bleeding and nose hemorrhage. But at the stage of easy diagnosis, the diagnosis of the disease is extremely difficult, so make sure the presence of the disease can only after a detailed medical examination.
The average degree is characterized by the manifestation of hemorrhagic rash over the body, which is numerous pinpoint hemorrhages under the skin and on the mucous membrane.
Severe degree of the same characterized by disorders of the gastrointestinal tract, caused by hemorrhages. The platelet counts in the blood have a value of up to 25×10 9 sup> / l.
Symptoms of secondary thrombocytopenia have similar signs.
Pregnancy and malaise: symptoms
Thrombocytopenia in pregnant women is characterized by significant differences in the quantitative composition of the bodies in the blood of women. If there is no diagnosis of the disease in pregnant women, but the platelet composition index is slightly reduced, this indicates that their vital activity is decreasing and participation in the periphery of the circulation is increasing.
If there is a decreased composition of platelets in the blood of a pregnant woman, then these are direct prerequisites for the development of the disease. The reasons for the reduced number of platelets are high degrees of death of these bodies and small rates of formation of new ones. Clinical signs are characterized by subcutaneous hemorrhage. The causes of deficiency of colorless bodies are the wrong composition and dietary norms or a small amount of food intake, as well as damage to the immune system and various blood loss. Through this, the body is produced by the bone marrow in small numbers or is an irregular shape.
Thrombocytopenia in pregnancy is very dangerous, so the issue of diagnosis, and especially treatment, is given maximum attention. The danger is that the lack of platelets in the mother’s blood during pregnancy contributes to the occurrence of a child’s hemorrhage. The most dangerous hemorrhage in the womb is a brain hemorrhage, the result of which is characterized by fatal consequences for the fetus. At the first signs of such a factor, the doctor decides about preterm labor to avoid consequences.
Pediatric thrombocytopenia: symptoms
Thrombocytopenia in children is rare. The risk group includes children of school age, the incidence of which is more often manifested in the winter and spring periods.
Thrombocytopenia and its symptoms in children are almost identical to adults, but it is important for parents at an early stage of the disease to diagnose it by first signs. To children’s symptoms are frequent bleeding from the nasal cavity and the occurrence of a small rash on the body. Initially, the rash occurs on the lower limbs of the body, and then they can be observed on the hands. With minor bruises, swelling and bruising occur. Such signs often do not cause concern for parents, due to the absence of pain symptoms. This is an important mistake, because any disease in a neglected form is a danger.
Bleeding of the gums indicates a deficiency of platelets in the blood both in the child and in adults. Cal at the same time in a sick person, and more often in children, stands out together with blood clots. Hemorrhage with urination is not excluded.
Depending on the degree of impact of the disease, immunity is distinguished from immune and non-immune platelet deficiency. Immune thrombocytopenia is caused by mass death of blood cells under the influence of antibodies. In such a situation, the immune system does not distinguish its own blood cells and is rejected from the body. Not the immune is manifested when the physical effect on the blood platelets.
A person is diagnosed at the first signs and symptoms of the disease. The main method of diagnosis is a clinical blood test, according to the results of which a picture of the quantitative composition of platelets is visible.
If there is a deviation in the number of blood corpuscles in the body, an indication is given for the passage of the bone marrow examination. Thus, the presence of megakaryocytes is determined. If they are absent, then thrombus formation has a violation, and their presence indicates the destruction of platelets or their deposition in the spleen.
The reasons for the occurrence of deficiency are diagnosed with:
- genetic tests
- tests for the presence of antibodies;
- ultrasound research
- X-ray and endoscopy.
Thrombocytopenia is diagnosed during pregnancy with the help of a coagulogram, or, in simple words, a study on blood clotting. Such an analysis allows you to accurately determine the composition of platelets in the blood. The number of platelets depends on the course of the process of birth.
Treatment of thrombocytopenia begins with therapy in which a drug called Prednisolone is prescribed in the hospital.
Important! Methods of treatment are prescribed strictly by the attending physician only after passing the appropriate examination and diagnosing the disease.
The dosage of taking the medication is indicated in the instruction according to which 1 ml of the drug is used per 1 kg of its own weight. With the progression of the disease, the dose increases by a factor of 1.5-2. At the initial stages, malaise is characterized by a rapid and effective recovery, so after taking the drug in a few days you can see an improvement in health. Taking the drug continues until the person is completely cured, which must be confirmed by the attending physician.
The effect of glucocorticosteroids has a positive effect on the control of malaise, but in most cases only symptoms pass, and the disease remains. Used to treat insufficiency in children and adolescents.
Treatment of idiopathic chronic thrombocytopenia is carried out by removing the spleen. This procedure in medicine is referred to as splenectomy and is characterized by its positive effect. In advance of the operation, the dosage of Prednisolone is increased three-fold. Moreover, it is not introduced into the muscle, but directly into the human vein. After the splenectomy, the drug is administered in the same doses up to two years. Only after the expiration of the specified period, an examination and examination of the success of the splenectomy performed is performed.
If the surgery for removal is unsuccessful, the patient is assigned immunosuppressive chemotherapy with cytostatics. These drugs include: Azathioprine and Vincristine.
With the diagnosis of acquired non-immune deficiency, thrombocytopenia is treated by symptomatic methods by taking estrogens, progestins and androxones.
More severe forms of idiopathic thrombocytopenia are caused by heavy hemorrhages. Transfusion is performed to restore blood. Treatment of severe degree causes the withdrawal of medications that may adversely affect the ability of platelets to form clots.
After diagnosing the disease, the patient becomes registered and there is a procedure for examining not only the patient, but also his relatives to collect a hereditary history.
In children, the malaise is treated well and without complications, but in some cases the possibility of symptomatic therapy is not excluded.
Treatment of thrombocytopenia with the help of traditional medicine also has its considerable achievements. First of all, to get rid of the problem of deficiency of platelets in the blood should be included in the diet of honey with walnuts. Broths from leaves of a nettle and a dogrose also well help. For preventive measures birch, raspberry or beet juice is used.