New treatment options for refractory ITP | New drugs (HBM9161)

ITP is a chronic heterogeneous disease that will have a major impact on the lives of patients, and treatment options are limited. So far, there are still many patients who are refractory and stubborn. New treatment options for refractory ITP|New drug (HBM9161) At present, clinical trials have been launched in medicine to evaluate the safety and effectiveness of HBM9161 in the treatment of adult immune thrombocytopenia (ITP). What kind of medicine is this? What is the therapeutic significance for ITP? HBM9161 is a fully human monoclonal antibody targeting the neonatal Fc receptor (FcRn), which can cause accelerated degradation of autoantibodies that drive primary ITP and other autoimmune diseases. For example, blocking FcRn to reduce IgG will bring hope to patients with refractory ITP! Doctors say that blocking FcRn to reduce IgG will provide a new and promising treatment plan for patients who do not respond to current therapies and/or are refractory to treatment. It is estimated that in the United States and China, the incidence of ITP among adults is 3.3 and 5-10 per 100,000 adults per year, respectively. The research and development of more and more new drugs brings hope of recovery to patients. Learn more about “disease knowledge” or “thrombocytopenia patient group communication” and other WeChat search public number: xxbjs1

Even if the platelets are slightly reduced, it should be taken seriously!

Xiebielu Studio WeChat add369456 article source: transferred from WeChat public account [Xiebielu Studio] In routine blood tests, the platelet count is lower than 100×109/L, which is called thrombocytopenia, which is a common disease in clinical blood. Regarding this disease, if the platelets are low to a certain degree, various symptoms of bleeding will occur. At the same time, thrombocytopenia is also a signal of some serious diseases. Therefore, even mild thrombocytopenia cannot be underestimated. In this case, you should first find a specialist to find out the cause, and take reasonable treatment according to different situations. There are many reasons for thrombocytopenia, some are accompanying manifestations of other diseases, common ones are: leukemia, aplastic anemia, myelodysplastic syndrome (MDS), which is caused by inhibition of platelet regeneration due to bone marrow disease. Rheumatic diseases can lead to increased platelet destruction. About one-third of the platelets in the human body are stored in the spleen. If the spleen enlarges due to other reasons, many platelets may be blocked in the spleen, resulting in a decrease in the number of platelets in the blood circulation. Certain viral or bacterial infections can also cause thrombocytopenia, such as epidemic hemorrhagic fever, hepatitis B virus, and HIV. Most of the patients with the above conditions are more complicated, rather than simple thrombocytopenia. The main treatment is to treat the primary disease. Of course, those with severe thrombocytopenia can also be transfused to prevent bleeding. Especially leukemia and infections should be detected and treated early to avoid life-threatening. If it is pure thrombocytopenia, some drugs have been used before or discovered during the treatment of other diseases, it is necessary to consider whether it is caused by drugs. Common drugs are: aspirin, indomethacin, phenytoin, carbamazepine, cephalosporin antibiotics, penicillin, streptomycin, sulfa, rifampicin, erythromycin, isoniazid, chlorothiazide, heparin, etc. There are many drugs that cause thrombocytopenia. In the above cases, you can read the instructions of the drugs used to see if there is a side effect of thrombocytopenia. If it occurs, you should consider it. Generally, platelets will rise after 1-7 days of stopping the drug. The first appearance of simple thrombocytopenia with no obvious cause, or long-term chronic simple thrombocytopenia, accompanied by skin bruising, may be the so-called “idiopathic” or “immune” thrombocytopenia (ITP), although it is generally known to be related to immunity , But the specific reason is still unclear. There are platelet antibodies in adult ITP, which leads to platelet destruction and maturation disorder. The bone marrow examination of megakaryocytes increases or is normal, accompanied by maturation disorder. If the above clear causes of thrombocytopenia can be excluded, it can be diagnosed as ITP. In the initial stage of western medicine treatment, glucocorticoids are generally used. If the effect is poor, consider danazol or immunosuppressive agents such as vincristine, azathioprine, rituxa, etc., and also consider platelet growth hormone. Western medicine treatment is effective, but there are also drawbacks. It is recommended that patients receive targeted Western medicine treatment while intervening targeted Chinese medicine and traditional Chinese medicine. The combination of Chinese and Western medicine can have a good effect. When platelets are very low, you should also pay attention: avoid strenuous activities, bed rest when extremely low, it is important to maintain emotional stability, and avoid spicy and spicy foods to avoid aggravating the condition.

Patients Sharing | Intractable ITP? My platelets go up

Patients share&nbsp.|&nbsp.Incurable diseases ITP? My platelets have gone up! This patient has been suffering from primary thrombocytopenia for a period of time. Like many unhealed patients, his condition has been fluctuating repeatedly. During the onset of illness, I heard other people’s recommendations to buy Aiqu for a while, but it did not improve. The prolonged condition caused a decline in the individual’s physical fitness. Coupled with mild anemia and poor complexion. At the same time, because of low blood platelets, I am always worried about bleeding and I feel a heavy burden. I used to think that diseases like the intractable disease ITP cannot be cured. Now through targeted medication treatment, the results have improved! Below is the comparison of the values ​​before and after the patient’s feedback (20 days after medication), which shows that recovery is not impossible! (Before treatment) (After treatment) Although thrombocytopenia is indeed an intractable disease within the scope of hematology, as long as the cause is clear, the disease is half healed. In the later stage, the treatment plan can be clearly determined according to the cause of the disease. Seeing more and more patients recovering from health, we must maintain good recovery confidence! Learn more about “disease knowledge” or “thrombocytopenia patient group communication” and other WeChat search public number: xxbjs1

Precautions for ITP withdrawal-doing these can reduce the recurrence rate

Although thrombocytopenia is difficult to treat repeatedly, it is a benign blood disease. With proper treatment, thrombocytopenia can achieve a stable clinical cure. For ITP patients who have reached this part of the goal, what should be paid attention to to prevent recurrence during the withdrawal phase? Precautions for discontinuation of ITP-Doing these can reduce the recurrence rate! Don’t reduce the medicine too quickly, but stop the medicine too hasty, but be steady, so as not to reduce the medicine too quickly and rebound. In addition, patients must undergo consolidation and prevention after the thrombocytopenia value is normal to ensure the efficacy of the drug withdrawal. Avoid two points. These two points are mainly the problem of colds and fever. Once it occurs, it is easy to reduce the immunity of patients with ITP, which will induce a decrease in platelet count, and the plan to stop the drug will be stalled. To avoid bumps, it is necessary to avoid traumatic bleeding as much as possible, which leads to excessive loss of platelet values ​​caused by excessive bleeding, which leads to abnormal fluctuations in values. It is best to avoid surgery (surgery in no rush) at this drug withdrawal stage and wait until the condition is completely stable before proceeding. Pay attention to the phase of dietary withdrawal, and pay special attention to the diet of patients with ITP. Do not overeating or eating or drinking spicy food at all. In addition, it is not advisable to eat foods that are too hard or crude fiber to avoid gastrointestinal bleeding. . Finally, there is a problem of pregnancy preparation-I have recently encountered many female ITP patients asking about pregnancy preparation. It is recommended to wait until the condition is stable before preparing for pregnancy. If the disease does not meet the cure criteria, pregnancy can easily lead to a sudden drop in platelet count. At that time, the pregnant mother and the baby will be affected. Learn more about “disease knowledge” or “thrombocytopenia patient group communication” and other WeChat search public number: xxbjs

Avoiding these 3 misunderstandings can promote better treatment of thrombocytopenia!

The course of thrombocytopenia is slow, and there are many reasons for thrombocytopenia, so the thrombocytopenia is easy to repeat and difficult to be cured. The clinical manifestations of thrombocytopenia are mostly bleeding, and severe bleeding tends to endanger the life of the patient. Therefore, in addition to increasing the platelet count, the patient must also prevent bleeding and avoid various misunderstandings! Avoiding these 3 misunderstandings can promote better treatment of thrombocytopenia! Blind diagnosis of thrombocytopenic purpura is an exclusive diagnosis, which must be combined with the patient’s medical history, examination results, multiple platelet counts, and other tests such as bone puncture to exclude other conditions and diseases that may lead to thrombocytopenia in order to diagnose ITP. In addition, the patient’s response to hormone therapy is also the basis for supporting the diagnosis of ITP. Therefore, it cannot be considered that all thrombocytopenia can be diagnosed as thrombocytopenic purpura. Overtreatment of ITP is an autoimmune disease. The purpose of early treatment is to raise the patient’s platelet value to a safe range, prevent severe bleeding, and reduce the mortality rate, rather than raising the platelet value to the normal range as the average patient thinks. Avoid overtreatment! If the platelets are lower than 30×10^9/L, or have bleeding symptoms, or are older, have been sick for a long time, or have coagulopathy, platelet function defects, or have high blood pressure, infection, trauma and other factors, therapeutic intervention is required. The treatment of patients with intractable treatment and relapse is more difficult. Patients must overcome pessimism, actively cooperate with treatment, and have patience and confidence during treatment. Common situations include frequent changes of doctors or experts, inattention to daily life, overwork, cold induction, etc. Avoiding these misunderstandings can better treat thrombocytopenia and obtain better curative effects. In fact, thrombocytopenia is not incurable. As long as the patient finds a suitable way and actively cooperates, after controlling the condition, some patients can even return to normal life without bleeding tendency. For more patient communication help, please follow the WeChat public account [Thrombocytopenia Patients Association] xxbjs75

What are the pharmacological effects of common Chinese medicines for thrombocytopenia?

Assistant Hu Guisheng WeChat: dd326751    Thrombocytopeniapurpura (thrombocytopeniapurpura) is a group of diseases that cause bleeding of the skin, mucous membranes or internal organs due to thrombocytopenia in the peripheral blood, which accounts for about 30% of the total number of bleeding diseases. Among them, idiopathic thrombocytopeniapurpur (idiopathicthrombocytopeniapurpur, ITP) has the highest incidence. ITP produces its own platelet antibodies due to the body’s immune function disorder, which increases the destruction of platelets and significantly reduces the platelet count in the blood routine. It is an autoimmune disease. It has long been recorded in Chinese medicine, and it is called “Grape Disease” in “The Sect of Surgery”, which belongs to the category of “aemia” and “spotting”. At present, there are many clinical treatment methods for this disease in western medicine, but the effect is not reliable. The application of traditional Chinese medicine has its own uniqueness, and the treatment of this disease has achieved better results by using the methods of promoting blood circulation to remove blood stasis, replenishing qi and nourishing blood. In the past ten years, there have been many reports on the treatment of thrombocytopenic purpura with traditional Chinese medicine. The author only summarizes the pharmacological mechanism of several commonly used prescriptions in the treatment of thrombocytopenic purpura. The main components of   rhubarb   rhubarb include emodin, chrysophanol, gallic acid, rhubarb polysaccharides and catechol. Chrysophanol can significantly increase the differentiation and maturation of bone marrow megakaryocytes, and increase platelet production and release. Rhubarb polysaccharides can increase the adhesion and aggregation ability of platelets. The two effective hemostatic monomers contained in rhubarb, namely d-catechin and gallic acid, can increase platelet adhesion and platelet aggregation, and can reduce the activity of antithrombin H (AT sub) to promote blood clotting. Gallic acid can also reduce fibrinolytic activity and promote blood coagulation. In patients taking rhubarb, the platelet electrophoresis time was significantly prolonged, and the platelet aggregation index was significantly reduced, indicating that rhubarb and its preparations have a certain blood-activating effect. Rhubarb can increase the osmotic pressure of plasma, transfer tissue water to the blood vessels to supplement the blood volume lost due to hemorrhage, reduce plasma viscosity, and help improve microcirculation disorders. Rhubarb’s thinning effect on blood is the pharmacological basis for promoting blood circulation and removing blood stasis. Astragalus edit Astragalus is an essential medicine for invigorating the middle and replenishing qi. Predecessors have discovered and applied its effects on promoting blood circulation. For example, the record of “Maintaining carbuncle and prolonged sepsis, draining pus and relieving pain” in “Shen Nong’s Materia Medica” actually contains The effect of promoting blood circulation and removing blood stasis. Astragalus can replenish qi to clear blood stagnation, smooth the channels and collaterals, take its power of nourishing qi and blood, and help other medicines to promote blood circulation and clear collaterals. Astragalus has anti-platelet aggregation effect and has obvious depolymerization effect on platelet aggregation. Its mechanism of action is to inhibit the activity of phosphodiesterase by inhibiting platelet calmodulin, thereby increasing the content of cAMP in platelets and inhibiting platelet aggregation. Astragalus has an obvious repairing effect on the damage of hematopoietic function, can prevent the reduction of bone marrow nucleated cells caused by cyclophosphamide, and promote the obvious recovery of the reduced number of white blood cells, platelets, reticulocytes and megakaryocytes.  Agrimonia    Agrimonia tannins and vitamin B contained in Agrimonia can increase the number of platelets and accelerate blood clotting. It has been clinically verified that when used in patients with bleeding, it has the effect of stopping bleeding. But pay attention to this. The drug properties converge and fix dampness. Single-medicine should be used with caution to prevent bleeding and stop blood stasis. At the time of the disease, the cold and heat deficiency should be distinguished first, and other drugs should be used. Agrimony 100g for the treatment of thrombocytopenic purpura; combined with Codonopsis, Ligustrum lucidum, Eclipta prostrata and wolfberry fruit, etc. have a good effect.  Angelica   Angelica polysaccharide and its sulfates can significantly prolong the clotting time, shorten the bleeding time, significantly prolong the thrombin time and activate the partial thrombin time, and its antithrombin effect mainly affects the endogenous coagulation system. While studying the anticoagulant effect of angelica polysaccharide and its lipid sulfate, it was found that it has two-way regulation, which can increase the viscosity of low-cut whole blood, enhance the aggregation of red blood cells, and promote the aggregation of platelets. Angelica can promote the hematopoietic function of bone marrow and spleen cells, and significantly increase the number of hemoglobin and red blood cells.   Panax notoginseng edit    Panax notoginseng saponins are similar to ginsenosides, but mainly ginsenosides Rbl and Rgl. Its effect is to stop bleeding, dissipate blood stasis, reduce swelling, and relieve pain. It stops bleeding without bleeding, removes blood stasis without hurting blood. Panax notoginseng warm soak and water-soluble ingredients notoginseng element. Panax notoginseng has the effect of replenishing blood, if it can restore anemia after hemorrhage, enhance hematopoietic function, and promote the proliferation of hematopoietic stem cells cultured in vitro

Why do hormonal drugs become less effective the more you eat? Pay attention to these adverse reactions!

Assistant Hu Guisheng WeChat: dd326751 thrombocytopenia is a blood disease, often bleeding, needs to be controlled, to a certain extent, we must control the management of the medication plan that suits me.  The commonly used immune preparations are:   1. Cyclophosphamide   The usual dose is 1-2mg/(kg·d), divided into two days. The onset is slow, and it takes effect after about 2 months. It is effective for 30% of patients with chronic ITP. High-dose cyclophosphamide 1-1.5g/m2 shock treatment, the effective rate is 70%, but due to severe side effects such as bone marrow suppression, liver and kidney toxicity, hemorrhagic cystitis, it should be used with caution. 2. Cyclosporin A (CsA) is a powerful immunosuppressant that inhibits the immune response of lymphocytes by inhibiting Th and releasing the cytokine IL-2 from cells. It acts on the early stage of lymphocyte proliferation, does not inhibit the hematopoietic system, and does not cause white blood cells and platelets. Reduce, suitable for refractory ITP. The usual dose is 4-7mg/(kg·d), orally in divided doses. At present, short-term use of small doses is recommended. Side effects include liver and kidney damage, gum hyperplasia, increased hair, high blood pressure, epilepsy and so on.  3. Etoposide (VP-16)    Platelets have abundant tubulin structure. VP-16 and platelets can form platelet-loaded drug couplings after incubation in vitro, and can form complexes with platelet antibodies in vivo. After being swallowed by monocytes and macrophages, VP-16 kills macrophages through cytotoxicity Cells, reduce platelet destruction. The efficacy of VP-16 in the treatment of ITP is currently uncertain, and its clinical application is rare. +  Estrogen plays an important role in the pathogenesis of ITP. Estrogen can inhibit platelet production and enhance the ability of monocyte-macrophages to destroy platelets. Antagonistic estrogen therapy is effective for some patients with refractory ITP.  1. Danazol    can regulate lymphocyte immune function and reduce platelet antibody production. The usual dose is 400-800mg/d, and the course of treatment is 2-3 months. It is suitable for male unpregnant women and older children. The effect is better when combined with glucocorticoids. Side effects include headache, nausea, rash, seborrheic dermatitis and liver damage. In order to alleviate side effects, low-dose (50mg/d, 5-7 months) treatment is recommended. 2. Tamoxifen is a non-steroidal estrogen competitive inhibitor that competes with estradiol for estrogen receptors on immune cells or cancer cells. Ts cell function defects caused by the combination of estrogen and Ts cells, Ts Increased cell activity can counteract the activation and proliferation of lymphocytes caused by Th cells and play an immunomodulatory effect. At present, 10mg is usually used, 3 times a day orally for 3 months. Suitable for refractory ITP.   Therefore, people with thrombocytopenia must seek medical treatment in time to find the real cause of thrombocytopenia, and take effective treatment measures as soon as possible to prevent the deterioration of the disease.

Thrombocytopenia Patients Association: How to divide the severity of the disease?

Everyone must have a basic understanding of the severity of immune thrombocytopenia. Simply put, the lower the value, the higher the risk. Regarding the severity of the disease, it is graded according to the number of platelets, divided into low-risk, intermediate-risk and high-risk groups, which are not consistent with the bleeding state. Values ​​from high to low-Immune thrombocytopenia is also divided into low-risk, intermediate-risk and high-risk low-risk ITP low-risk refers to the number of platelets between 50 and 100, such patients are recommended to work and study normally, participate in all Social activities. Intermediate-risk ITP high-risk refers to the number of platelets between 30 and 50. What the patient needs to do at this time is dynamic observation and active drug intervention at the same time. High-risk ITP High-risk refers to the number of platelets between 10 and 30, that is, less than 30. We directly become high-risk patients with thrombocytopenia. This part of patients must actively intervene regardless of whether there is bleeding, and appropriately limit the workload and our daily routine. life. For patients with thrombocytopenia, if your platelets are lower than 10 at the time of the review, then you are already in a very high-risk group. At this time, we must pay great attention to it. It is recommended to be hospitalized in time for treatment and raise the value to safety as soon as possible. Level (platelets below 10 are prone to intracranial hemorrhage and internal organs, such as stomach and intestines, which are prone to severe internal organ bleeding, which directly affects life danger). Learn more about “disease knowledge” or “thrombocytopenia patient group communication” and other WeChat search public number: xxbjs1

Thrombocytopenia Patients Association: What is the effective rate of spleenectomy treatment?

Splenectomy is generally suitable for patients with chronic ITP, frequent recurrent attacks, or severe drug dependence but continuous disease progression. Before surgery, it is necessary to confirm whether the patient is necessary for spleenectomy and whether the patient has surgical contraindications. Regarding the question of a whole spleenectomy, the answer: No. Clinically, it is said that 10% of patients who relapse after splenectomy are caused by the accessory spleen. Therefore, some physicians will advocate that the accessory spleen should be found and removed as much as possible during splenectomy. Approximately 15% to 20% of patients may find an accessory spleen during splenectomy, and some patients have multiple small accessory spleens. Supplement-How efficient is ITP to cut the spleen? ①The continuous complete response reached 66.7%; ②The stable partial response rate was 14.3%. The main effect of cutting the spleen on the body lies in the immune system. Whether the spleen cut is effective for thrombocytopenia depends on the platelet changes after the spleen cut. Generally, the platelet rise is very rapid in effective cases. It is not common to find that the platelet value rises after several days or 10 days. The recurrence after spleenectomy can occur within a few months after the operation, and there are also cases of short-term or 2-3 years after the operation. Learn more about “disease knowledge” or “thrombocytopenia patient group communication” and other WeChat search public number: xxbjs1

What is the effect of traditional Chinese medicine interventional hormone therapy for thrombocytopenia?

Assistant Hu Guisheng WeChat: dd326751 idiopathic thrombocytopenic purple scar is an immune-mediated thrombocytopenia syndrome, which accounts for about 30% of bleeding diseases. It is more common in skin and mucosal bleeding, and severe intracranial hemorrhage may also occur; It belongs to the categories of “purple spot”, “grape disease” and “blood syndrome” in traditional Chinese medicine, and it is called “purpura disease”. 80% of adult ITP is a chronic process. Due to viral infections and other factors, it is very easy to repeat, which seriously affects the quality of life. In recent years, the incidence rate has gradually increased, which is more and more worthy of attention. Therefore, the use of traditional Chinese medicine to treat platelets with interventional hormones is divided into three steps:    1. Chinese medicine combined with hormones enhances clinically, combined with hormones to treat ITP. Nourishes Yin and lowers fire, cools blood and calms collaterals, Qiangen San and Dabuyin Pills add and subtract; Qi does not absorb blood type to invigorate qi and invigorate spleen to absorb blood, and Guipi Decoction is added or subtracted. The total effective rate is 93%, which is higher than the single use of hormones. The control group was 13%. The treatment is divided into four types. The blood-heat safe type is modified with rhinoceros dihuang decoction; the Yin-deficiency and fire-prosperous type is modified with Qiangenjing; the qi deficiency type is not taken with the Guipi Decoction plus Caulis spatholobi, notoginseng, blood residual charcoal, and palm charcoal. The treatment of blood stasis blocking collaterals is to promote blood circulation, remove blood stasis, calm collaterals to stop bleeding, and use Taohong Siwu Decoction to add or subtract; the total effective rate is 86.67%.   Throughout the literature, the combination of traditional Chinese medicine and hormone therapy for ITP has obvious advantages over the hormone alone group, and it is an extremely worthy program. Clinically, the prescription drugs for syndrome differentiation and treatment are adopted by most doctors and gradually unified. The reports on disease differentiation and treatment are mostly self-developed prescriptions, empirical summaries or individual cases. The regularity of medication is not strong, and the treatment points are quite different, and it is difficult to guarantee the efficacy. Reproducibility, but does not depart from the scope of liver, spleen and kidney, heat deficiency and blood stasis; among them, treating ITP from the liver is a treatment method that has been explored in recent years and has a positive effect. Chaihu formulas have shown good results in refractory ITP and dependent ITP. Momentum, and is expected to be used for hormone resistance.  2. Chinese medicine to overcome hormone resistance   hormone resistance refers to a decrease in response to hormone therapy or even no response at all. Because GC mainly specifically binds to glucocorticoid receptor (GR), it exerts physiological effects. The resistance mechanism is mainly based on the decline of GR level. The study found that the GR decreased in patients with kidney-yang deficiency, and the white blood cell GR in the elderly and patients with deficiency syndrome decreased, and it was determined that the hormone resistance is mainly the syndrome of kidney-yang deficiency; the warm-yang medicines such as Epimedium can increase the expression of CR protein and can antagonize the adrenal glands. Excessive cortex apoptosis protects the function of adrenal cortex. 3. Chinese medicine-assisted hormone attenuation clinically found that after hormone therapy, patients often have symptoms of yin deficiency and fire, such as dry mouth, desire to drink, upset and dreams; long-term use of hormones, especially in the hormone reduction stage, may cause immune function decline, dizziness, tinnitus, etc. Insufficiency of kidney qi, the study uses prescriptions for nourishing yin and replenishing kidney (Shu Dihuang, Polygonum multiflorum, Polygonatum, Dendrobium, Ligustrum lucidum, Eclipta prostrata, Caulis spatholobi, Morinda citrifolia, Cornus officinalis, Gallus gallus) , Can stabilize the number of platelets, the rebound rate is only 12.5%, and the rebound rate of the control group is 33.33%. Glucocorticoids, as the first choice for the treatment of ITP, have definite but unsatisfactory curative effects, especially in the presence of stimulus resistance and dependence. The combination of traditional Chinese and Western medicine has made great progress in enhancing the effectiveness of hormones and reducing toxicity. Modern Chinese medicine pharmacology and clinical research are also in progress. Unremitting exploration of hormone-resistant ITP and hormone-dependent ITP, traditional Chinese medicine intervention has become more and more accepted and selected by patients. However, there are few experimental studies, some clinical reports are only the experience of a few doctors, and the case data is small, and it is difficult to guarantee its guidance and reproducibility of curative effects. It is necessary to further improve the pathogenesis, syndrome types and prescription drugs; and a reasonable prospective design is required Clinical research provides support for evidence-based medicine; how Chinese medicine can further improve the curative effect and prevent repeated treatments requires further exploration.

Hu Guisheng, Beijing Hematology Hospital: Warn ITP patients not to become addicted to drugs!

Assistant Hu Guisheng WeChat: dd326751 Article source: Reposted from the WeChat public account [Hu Guisheng Studio] Most patients with ITP need long-term medication, because this disease often has a long course of disease, even if it is a reasonable and standardized treatment, it is difficult for the body to be in a short time Rehabilitation, and its treatment medications are mostly androgens, immunosuppressants, cyclosporine, etc., long-term medication has large side effects, and sudden withdrawal may also cause side effects or rebound of the disease.   In fact, after the condition improves, it is not so difficult to reduce or stop the drug. The main reason is to consider both the condition and the efficacy of the drug. Taking hormones as an example, the principle of “long-term maintenance and slow drug reduction” should be followed. Some patients with purpura nephritis will turn proteinuria into negative in time, and still need to take drugs, mainly to inhibit inflammation, not only to reduce protein, but slowly Reducing the drug allows the body to maintain a certain blood concentration, and stopping the drug after the body adapts, the risk of recurrence will be lower.   In addition to hormones, immunosuppressants and other drugs, other drugs, such as diuretics, Chinese medicine, etc., are also used in the treatment of ITP patients. The purpose of taking medicine is to treat diseases, and to reduce relapses, suffer less, and spend less money. How to have one medicine and never use two medicines to reduce the burden on the kidneys and improve the effect of protecting the kidneys.   It is especially emphasized that if the patient is dependent on the drug due to the use of the drug during the treatment, the dose should be gradually reduced until it is completely removed. “In summary, ITP patients are drug-dependent, and have a tendency to relapse during hormone reduction. Targeted traditional Chinese medicine prescriptions can stabilize platelets after interventional therapy, and Chinese medicine combined with hormone therapy can quickly take effect. Under the continuous action of traditional Chinese medicine, the reduction of hormones is significantly faster than the conventional hormone reduction rate without traditional Chinese medicine. It shows that the combination of traditional Chinese medicine and hormones is higher than the therapeutic effect of hormones alone. However, there are many treatment directions for the combination of Chinese and Western medicine. Among them, it is not ruled out that patients who have relapsed after the complete reduction of Chinese and Western medicines. It is necessary to change the treatment thinking. While benefiting the marrow and lifting the plate, it is also necessary to adjust the patient’s autoimmune disorders. problem. Please keep in mind that the process of TCM treatment is not a prescription. It is necessary to constantly add and subtract prescriptions and adjust the course of treatment according to changes in the condition. Otherwise, it will be difficult to follow up the pace of disease changes with immobilized TCM, whether for platelets. This is true whether the condition improves or worsens.

Thrombocytopenia: Will a diagnosis of refractory mean that there is no cure?

Clinically, it is generally considered that cases of ineffective glucocorticoid, gamma globulin therapy and/or splenectomy treatment are refractory ITP. Faced with the word “refractory”, many patients wonder whether this means that there is no cure? Relevant analysis is made below. Ps: diagnostic criteria for supplementing refractory ITP ① glucocorticoid and splenectomy treatment are ineffective; ② there is no other disease that may cause thrombocytopenia; ③ platelet count ≦10×109/L; ④ ITP course is more than 3 months; refractory platelets Isn’t the diminishment better? In general, the value of refractory thrombocytopenia is very low all year round, generally in the single digits, and it continues to be associated with complications and the risk of internal bleeding. But it is not hopeless. The treatment of refractory ITP is mainly high-dose shock therapy, cyclosporine, immunosuppressive agents, etc. Part of it will involve imported supportive maintenance treatment. In addition, targeted Chinese and Western medicine combination is also very likely to reverse the status of refractory thrombocytopenia. If you have any questions about this article or the disease, please feel free to follow us on WeChat and search more: xxbjs1

Treat the thrombocytopenia with the traditional Chinese medicine treatment method of invigorating the spleen and invigorating the blood!

Hu Guisheng Assistant WeChat: dd326751   Immune Thrombocytope-nia (ITP) is an acquired autoimmune hemorrhagic disease with an incidence rate of (5-10) per 100,000 population, which can occur at any age Among them, middle-aged women and elderly people over 65 years old are a high-risk group. The clinical manifestations of ITP are mainly extensive skin and mucous membrane bleeding. People with acute onset may have life-threatening visceral hemorrhage or cerebral hemorrhage, and the risk of bleeding increases with age, but it is not consistent with the decrease in the number of peripheral platelets in patients, especially chronic patients Even if the platelet count is not at a safe level, extensive or severe bleeding will not occur.   Therefore, for the treatment of ITP, in addition to effectively preventing bleeding and stabilizing peripheral platelet values ​​at a safe level, it is very important to control or improve the clinical symptoms of patients. Clinical practice has proved that TCM-based or adjuvant therapy has obvious advantages in preventing and treating ITP patients with bleeding, stabilizing peripheral platelet values, and improving clinical symptoms. However, the effect mechanism of TCM therapy needs further study. With reference to “Guiding Principles of Clinical Research on New Drugs of Traditional Chinese Medicine” in “Guiding Principles of Clinical Research on New Drugs of Traditional Chinese Medicine” and “Guiding Principles of Clinical Research on New Drugs of Qi Treatment of Qi Deficiency Syndrome”, formulate the standard of “Spleen Failure to Control Blood Syndrome” based on the clinical characteristics of the disease:   1. Chronic hemorrhage (repeated subcutaneous petechiae or ecchymosis, pale color, excessive menstruation or prolonged menstruation, etc.), accompanied by fatigue, fatigue, and laziness;    2. Second symptom loss of appetite, abdominal distension after eating;    3. Tongue pulse tongue The body is fat and large, with tooth marks on the edges and pale tongue; the pulse is weak.  ITP is an acquired autoimmune hemorrhagic disease caused by abnormalities of multiple links, multiple targets and multiple steps. The pathogenesis is that the patient is immune intolerant to its own platelet antigen. Under the mediation of humoral immunity and cellular immunity, the destruction of platelets is increased and the production is inhibited, resulting in the breaking of the dynamic balance between platelet production and destruction. Peripheral platelet counts decrease, and skin or mucous membrane bleeding often occurs. People with acute onset may be life-threatening due to severe bleeding. After previous research, Chinese medicine treatment of ITP has the advantages of obvious clinical symptoms, stable efficacy, and fewer adverse reactions. Chen Xinyi and others believe that ITP is closely related to “splenic incontinence of blood”, and advocate the treatment of spleen and qi and blood intake, and In clinical practice, we not only pay attention to the increase of peripheral platelet values ​​in patients, but also pay more attention to the improvement of clinical symptoms and the control of bleeding tendency. The Jianpi Yiqi Shexue prescription is composed of astragalus, codonopsis, Poria, Atractylodes macrocephala, donkey-hide gelatin, madder, and licorice root. Among them, the astragalus is warm and sweet, and it has a spleen and lung meridian. The main effect is to strengthen the spleen and qi and solidify the table. The patients with “spleen failure to control blood” seen in the clinic mostly show lower body bleeding, such as purpura and ecchymosis , The menstrual period is more or less dripping, and the addition of astragalus is also the longevity of its beneficial qi, so it is a king medicine; Dangshen, Poria, Atractylodes three medicines are the subjects, and the meaning of the four gentlemen’s soup is taken to treat the foundation of spleen and stomach qi deficiency syndrome. Fang strengthens the power of strengthening the spleen and qi; Ejiao is a traditional sacred medicine for nourishing blood, sweet and calming, returning to the lungs, liver and kidney channels. Meridian, cooling blood to stop bleeding, Ejiao and Rubia grass as adjuvants, can not only increase the hemostatic power, but also prevent blood stasis or blood fever by removing excessive blood stasis, nourishing yin and cooling blood to prevent excessive supplementation of monarch medicine and official medicine Acting arrogantly, so that the prescription can take blood without leaving blood stasis, and nourish the blood; the licorice root is used as a medicine, Yiqi and middle and harmony medicines, and plays the role of invigorating the spleen and qi and invigorating the blood.  In summary, Jianpi Yiqi Shexue Recipe can effectively improve the bleeding symptoms of ITP patients with “spleen incompatibility” and improve the peripheral platelet count of patients, which can effectively improve the TCM syndromes and single symptoms of ITP patients. Its therapeutic mechanism may be related to peptide neurotransmitters that regulate the brain-gut axis.

Xie Bielu’s medical remarks: What do parents care about most if their child has thrombocytopenia?

Children are very common among people with immune thrombocytopenia (ITP). For parents of children diagnosed with thrombocytopenia, in addition to worrying about the impact of the disease on their children’s health, it will also consider whether the child’s future growth will be affected. Director Shi Shurong’s WeChat consultation platform: zkxk9999 Here are some questions that parents care about. I will give you a detailed answer: the impact of thrombocytopenia on children’s future life and learning: ITP will not have much impact after standard treatment. However, children with ITP may be more fatigued than normal children, and their quality of life will be affected. Therefore, children may have fewer outdoor activities than other children. Do you need to take drugs that boost immunity: Parents don’t need to give their children drugs that boost immunity. Children only need to live a healthy life and avoid going to places where there are many people and cross infections are likely to occur. Frequent outdoor activities, open windows for ventilation, a reasonable diet, a reasonable mix of vegetables, meat and poultry, a combination of work and rest, to avoid fatigue, then the immune system is at its best. What should parents do to monitor their child’s condition? Parents need to pay attention to whether the child has bleeding conditions, whether the skin bleeding points have increased, whether there is nose bleeding, gum bleeding, etc. If you find that your child has bleeding, you should consult a doctor if possible and go to the hospital in time. What should I do if my child has bleeding spots? Parents still mainly observe the skin and mucous membranes. In general, the most susceptible to bleeding on walking is the lower leg, followed by the part that often exerts force. For example, if you walk normally and walk for 100 meters, the child has more bleeding points than the average person; or when you take a bath and rub the bath with the same intensity, the child has bleeding skin and mucous membranes, but the average person does not. Or in the same environment, other children do not have nosebleeds, and children always have nosebleeds, which requires special attention. If it is found that the child has bleeding tendency, parents should not panic, go to the child in time and let the doctor deal with it. In addition, children’s mental health should also be emphasized. The occurrence of thrombocytopenia not only harms the health of children, but also may cause children to have an inferiority complex in front of children of the same age. Therefore, parents must patiently care and carefully guide their children to actively cooperate with treatment, so that children can get rid of the disease and recover as soon as possible. health. More patient communication help can pay attention to the WeChat public account: Thrombocytopenia Patient Association

Shi Shurong’s medical words: The immune thrombocytopenia you want to know is here!

Immune thrombocytopenia (ITP) is an acquired autoimmune disease. It is the most common hemorrhagic disease caused by the decrease in platelet count seen clinically. Clinical manifestations of platelet count decreased to varying degrees, with or without skin and mucous membrane bleeding symptoms. ITP can occur at all ages. Generally, children are acute and adults are chronic. Director Shi Shurong consulted WeChat zkxk9999&nbsp.&nbsp. Most children with immune thrombocytopenia had a good prognosis. Here we have a comprehensive understanding of some common sense of immune thrombocytopenia: incentive: ITP: children have a history of infection before onset, which can be as high as 60%. Respiratory tract infections are common, mainly viral infections. In terms of bacteria, Helicobacter pylori infection may be one of its pathogenic factors. In children with acute ITP, the positive rate of HpIgG antibodies is 40.54%, and the positive rate of Hp IgG antibodies in children with chronic ITP is higher. There is no need to eradicate it. A unified statement of Hp infection, but a few reports show that Hp eradication can shorten the course of ITP and reduce recurrence, even if Hp eradication has no effect on the long-term treatment effect of ITP. In terms of immunization, the measles-rubella-mumps mixed vaccine (MMR) can induce the occurrence of ITP, but most of them have a good prognosis. The diagnosis has no specific diagnostic criteria and is an exclusive diagnosis. Generally, at least two blood routine tests show a platelet count of 100×109L, with or without skin bleeding, and other clinical manifestations. Excluding other secondary thrombocytopenia, such as hypoproliferative leukemia, Aplastic anemia and infection can only be diagnosed. Among them, whether a newly diagnosed ITP patient undergoes bone marrow aspiration examination to rule out other hematopoietic system diseases is currently inconclusive, and this examination is not recommended abroad, but domestic scholars recommend that those with clinical symptoms and signs and laboratory tests are not typical Before the use of glucocorticoids, refractory ITP and splenectomy before bone marrow puncture, repeat puncture if necessary. Classification New diagnosis ITP: course of disease 3 months; persistent ITP: course of disease 3-12 months; chronic ITP: course of disease 12 months. Treatment increases the number of platelets to a safe range to prevent major bleeding, without raising platelets to normal levels. It is generally believed that those with a platelet count of 30x109L and no obvious bleeding manifestations should not be treated and observed closely. Platelet count 30x109L, or with bleeding symptoms, or those with bleeding tendency can be treated regardless of the degree of platelet reduction. 1. First-line treatment (1) Prednisone, a glucocorticoid 2 mg (kg.d), can be administered intravenously at the beginning. After the platelet rebounds, it should be taken orally, and the dose should be gradually reduced to 3 to 4 weeks. If prednisone does not respond after 4 weeks of treatment, it should be rapidly reduced to discontinuation to assess whether the diagnosis is correct. (2) The common dose of gamma globulin (IVIG) is 0.4 to 1 g (kg.d) for 2 to 5 days, which can quickly increase the number of platelets. (3) Anti-D immunoglobulin 75ug (kg.d), 1 to 3 days, suitable for non-splenectomy children with Rh+, but it is not recommended for hemorrhagic anemia or autoimmune hemolytic anemia. 2. Second-line treatment (1) Glucocorticoid shock treatment of dexamethasone 1.5~2.0mg (kg.d) shock for 4 days or methylprednisolone 15~30mg (kg.d), change to prednisone 3 days after shock 1~2mg (kg.d) is taken orally. For the treatment of persistent or refractory ITP. (2) Anti-CD20 monoclonal antibody rituximab 375mgm2 intravenously, once a week, a total of 4 times, this is the standard regimen, the low-dose regimen dose was changed to 100mgm2. (3) 1mg (kg.d) of thrombopoietin recombinant TPO, used for 2 weeks, is used to treat refractory ITP. (4) Immunosuppressants such as cyclophosphamide, azathioprine, etc. (5) The indications for splenectomy are: those who are ineffective after regular medical treatment; platelet count 10X109L, those with life-threatening severe bleeding or urgent need for surgery; the course of disease is 1 year, age 5 years old; there are contraindications for the use of glucocorticoids By. Inoculation of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae 2 weeks before surgery. Prophylactic use of penicillin after surgery can reduce the mortality of postoperative children. 3. When emergency treatment of severe ITP shows a life-threatening bleeding manifestation, methylprednisolone may be given a shock of 10-30 mg (kg.d) in combination

Thrombocytopenia refractory? Mainly because of these misunderstandings! Shi Shurong Consulting

Clinically, there are many methods for the treatment of thrombocytopenic purpura, including: hormonal drugs, immunosuppressive agents, spleen cutting, traditional Chinese medicine, integrated Chinese and Western medicine, etc., but many patients still have repeated attacks and even develop into refractory Thrombocytopenia. Director Shi Shurong’s micro-signal xueyeke999 Because this disease is not common in daily life, many patients still do not know what kind of disease is thrombocytopenia even if they are sick. This also leads to over-treatment, drug resistance, poor treatment compliance, unsatisfactory results, and frequent recurrence of the disease, causing everyone to lose confidence in the treatment. In fact, many refractory and relapse-prone patients are still effective in re-treatment, even after standardized treatment can achieve the effect of rehabilitation and recovery, and the reason for this is not related to some of the treatment misunderstandings that occurred during the treatment of patients . Everyone’s misunderstandings about thrombocytopenic purpura mainly include the following aspects: 1. Unexplained thrombocytopenia is the diagnosis of ITPITP is an exclusive diagnosis, and the current diagnosis of ITP is still lack of “gold standard” or specific diagnostic indicators, basic It is still an exclusionary diagnosis. It must be combined with the patient’s medical history, physical examination, multiple platelet counts (sometimes manual counting), peripheral blood smears, platelet autoantibodies, and even bone marrow smears and biopsies to exclude other thrombocytopenia before it can be eliminated. Diagnose ITP. In addition, responding to hormone therapy is also an important basis for supporting ITP diagnosis. Therefore, the low number of platelets cannot be seen, and the “real cause” cannot be found for a while. ITP is diagnosed without corresponding investigations to avoid misdiagnosis and incorrect treatment. It is recommended that patients be diagnosed and treated in regular, qualified hospitals! 2. The goal of overtreatment ITP is to increase the number of patients’ platelets to a safe range, prevent severe bleeding, and reduce the mortality, rather than bringing the number of platelets to the normal range. It is not necessary to maintain the patient’s platelet value within the normal reference value range. For patients in need of treatment, it is necessary to combine the risk of bleeding, efficacy, side effects, and patient compliance, comprehensively consider, weigh the pros and cons, and adopt appropriate individualized treatment to minimize the side effects of drugs without affecting the efficacy. 3. Incomplete treatment of glucocorticoids (hereinafter referred to as hormones) is the first choice for the treatment of ITP. If the patient’s platelets have not increased after 4 to 6 weeks of hormone treatment, indicating that prednisone therapy is ineffective, it should be rapidly reduced to stop . In the clinic, three situations are often encountered that lead to inadequate treatment: one is that the hormone loss is too fast, and the reduction begins when the platelets are not yet stable, or the reduction is too fast after stabilization. The second is to stop the drug too early and do not do maintenance treatment. The third is the insufficient amount of hormones, including the starting dose and maintenance dose, mainly to worry about many side effects after long-term application. Patients should use the medicine according to the doctor’s orders, they cannot stop the medicine by themselves and give up their previous achievements, nor can they reduce the amount of hormone by themselves to affect the curative effect. 4. Patients with refractory and relapsed treatment problems. Patients should overcome pessimism, actively cooperate with treatment, and have patience and confidence during treatment. Common conditions include frequent doctor or expert changes, inattention to daily life, overwork, and cold induction. Patients should properly cooperate with traditional Chinese medicine treatment. Traditional Chinese medicine has certain characteristics and advantages in combination with hormone reduction, side effects and bleeding reduction, especially for patients with relapse and refractory treatment. All in all, the treatment of thrombocytopenic purpura, we must first have a clear understanding of the disease to avoid misdiagnosis. Furthermore, it is necessary to choose a suitable treatment method to avoid over-treatment and incomplete treatment. Finally, patients need to be patient with the treatment and actively cooperate with the treatment. More thrombocytopenia disease knowledge or patient help can pay attention to WeChat public number: xxbjs75

These four conditions are high-risk factors for patients with thrombocytopenia!

Thrombocytopenia is common in patients with low platelet values. The main risk factor of this disease is related to bleeding. For patients without wet bleeding, it is much safer than ITP patients with bleeding tendency! In addition, there are some factors that constantly threaten and increase the risk of ITP patients. [Alert] Low platelet values ​​will be more dangerous with these four conditions! Cold, fever, and fever are related to the patient’s physique, mainly due to physical weakness, weakened disease resistance, and central dysfunction in temperature regulation. For patients with immune thrombocytopenia, this phenomenon is likely to cause fluctuations in immune disorders, resulting The value appears repeatedly. The common thrombocytopenia patients with the original seventy or eighty values ​​have platelets as low as twenty or thirty or even lower as soon as they catch a cold and fever! Hypertensive platelet reduction is clinically divided into two types: primary and secondary. Secondary thrombocytopenia should exclude chemical factors, physical factors, drugs and certain immune diseases. Some drugs can cause thrombocytopenia, including some antihypertensive drugs. Patients with hypertension all need to take antihypertensive drugs on a daily basis, so for patients with thrombocytopenia complicated with hypertension, the condition will be aggravated. If drugs are considered, antihypertensive drugs can be used instead. Older and older patients with thrombocytopenia are more likely to have the risk of complications than younger patients. The common bleeding manifestations are also more invasive due to the disease itself in the elderly, so the formulation of treatment plans and the use of drugs and dosage will be more limited. Treatment is not good. In addition to the above high-risk factors, wet bleeding has obvious bleeding symptoms and bleeding tendency, which is undoubtedly a direct harm to the disease, such as oral blood bubbles, nose bleeding, tooth bleeding, heavy menstrual flow, urine blood, gastrointestinal bleeding, quite It is severe intracranial hemorrhage! In summary, patients with thrombocytopenia need to identify unfavorable factors, actively receive treatment, and try to avoid and reduce the risk of high-risk complications. At the same time of treatment, daily protection should also be done. The diet is mainly light, and the coix kernels, yam, guoshi, lotus root, etc. should be eaten. Eat less or no dry hair such as lamb, dog meat, hot pot, fish, shrimp and seafood (especially for ITP patients who are also taking traditional Chinese medicine). If you have any questions about this article or the disease, please feel free to follow us on WeChat and search more: xxbjs1

How to treat patients with paroxysmal chest tightness after 30 years of thrombocytopenia?

The 77-year-old man has been suffering from thrombocytopenia for 30 years. Occasionally, chest tightness and post-sternal cramping occasionally appear at the beginning of exercise. There is relief after 2 to 3 minutes. Later, he went to the hospital for treatment, and was treated with isosorbide mononitrate 40mg (qd). Afterwards, the patient developed chest pain at rest, radiated to the left arm, accompanied by cold sweat, no dizziness, nausea and vomiting, blurred vision, etc., continued to relieve after nearly half an hour, without taking nitroglycerin. Chest pain increased significantly and the number of episodes increased. At night, he could not lie on his back and awakened with pain. Later, due to severe chest pain, which could not be relieved, he went to the local hospital for examination. After examination, the patient had no platelet percutaneous coronary intervention (PCI) because of low platelets (8X10 * / L). After the operation, please consult with the hematology department to improve the bone marrow aspiration: bone marrow nucleated cell proliferation is active. There are 8 whole megakaryocytes, 1 plate type, 6 granular types, 1 naked nucleus, and very small clusters of platelets scattered on the tablet are easy to see . Combined with the previous medical history, considering the possibility of immune thrombocytopenia, the patient was treated with methylprednisolone 60mg intravenously for 3 days and changed to prednisone 30mg oral treatment, and the platelet rebounded to 93X10 * / L. After giving patients cilostazol 50 mg and clopidogrel 50 mg antiplatelet therapy, PCI was performed under local anesthesia in late June 2010. Antiplatelet drugs were discontinued 3 months after surgery, and prednisone was regularly reduced to 5 mg, and the patient had no bleeding. ITP is a disease that causes excessive platelet destruction mediated by the immune system and leads to thrombocytopenia, which can be secondary to skin and mucous membrane and visceral bleeding. It has been previously believed that thrombocytosis is one of the risk factors for CAD and acute myocardial infarction, but research suggests that the risk of cardiovascular disease in ITP patients is 1.38 times that of non-ITP patients. ITP patients treated with splenectomy have a higher risk of cardiovascular disease. The risk of arterial embolism in ITP patients is 1.5 times that of non-ITP patients, and the risk of venous thromboembolic events is 1.9 times that of non-ITP patients. This may be related to the large platelet size and strong adhesion ability of ITP patients. Large platelets have a stronger hemostatic effect, have a tendency to thrombosis, and have a potential risk of myocardial infarction; autoantibodies may damage platelets at the same time. The endothelium also has a damaging effect; while treatment methods such as hormones may lead to hypercoagulability of the blood, and secondary metabolic changes may also promote the progression of atherosclerosis, which is related to the occurrence of cardiovascular events. ITP is a risk factor for venous thromboembolism, but has little effect on arterial thrombosis. Increasing age and men are the most important risk factors for arterial thrombosis in ITP patients, and increasing age also increases the risk of venous thrombosis. Therefore, when the preoperative platelet count is lower than the lower limit of surgery, hormone or gamma globulin shock therapy can be applied until the degree of tolerability of surgery. Although gamma globulin can increase platelet count, it also increases the risk of thromboembolic events. Balloon angioplasty is used to treat patients with ITP and acute myocardial infarction, which avoids stent implantation and reduces the risk of bleeding. Patients with ITP and CAD can safely undergo PCI. After balancing the risk of bleeding and embolism after surgery, consider a more aggressive antithrombotic strategy, that is, as long as possible antiplatelet therapy.

Correctly understand the saying of “self-healing” of thrombocytopenia!

Does the “self-healing” of primary thrombocytopenia really exist? Many family members listened to this statement and gave up treatment. Clinically, there are more than 10 children who have not received treatment for a long time and eventually have a serious risk of serious complications. For this, it is necessary to re-understand the “self-healing” of ITP. statement! ! What is ITP “self-healing”? Understand: mostly because of the child’s immune deficiency, imperfection, and this disease happens to be mainly immune lesions. Therefore, with the increase of age, the immunization gradually improves, it is possible to achieve self-healing, and platelets return to normal . However, at this stage, you need to understand: ①: Compared with adult ITP, the onset of ITP in children is more rapid, and patients with bleeding symptoms will be more severe than this. If the platelet value is too low, especially in the state of twenty or thirty , Need to take active treatment, can not put the risk that the disease may bring to the child in the second place; ②: self-healing does not mean no treatment, the early onset value of this disease is low, and fewer shock treatments can be performed, Most cases can be cured within three months, and the prognosis of this group is very good. In addition, about 20% of cases will develop chronic ITP, the course of disease is generally greater than 12 months. It needs to be emphasized that the severity of bleeding in children is negatively correlated with platelet count, but clinically it is often found that some children have severely reduced platelet count, but there is no serious bleeding manifestation. Therefore, judging the degree of bleeding and formulating treatment plan by platelet count Incomplete, we need a more comprehensive bleeding assessment tool. For children with ITP who have bleeding manifestations, the severity varies, mild cases only accidentally find thrombocytopenia in the blood routine but no bleeding symptoms, or only a few petechiae, petechiae, severe cases can be intracranial bleeding or gastrointestinal bleeding As a primary manifestation, physical examination revealed bleeding in the oral mucosa and nasal mucosa. Need to actively assess the situation to carry out the treatment, do not regret the risk before it happens! If you have any questions about this article or the disease, please feel free to follow us on WeChat and search more: xxbjs1

How to treat poor myelodysplasia with low platelets? Shi Shurong Consulting

Clinically, many patients with low platelet values ​​are confused during the diagnosis and treatment of their own examination results. On the one hand, they do not understand what is going on with the disease? On the other hand, it is not clear whether the disease is serious or not? How to treat? Director Shi Shurong Wechat xueyeke999 Patient consultation: Doctor, had thrombocytopenia, hospitalized, had small meganuclease test, 122 megakaryocytes were detected, including 117 normal meganucleus, 5 round nucleus, bone marrow examination said yes ITP, iron deficiency anemia. Barriers to maturation of the meganucleus system, as well as poor bone marrow hyperplasia. The platelet value is now 32. Is this a serious condition, and how should it be treated? Hematologist: Diagnose whether it is ITP and iron-deficiency anemia, also need to check the patient’s immune function, exclude secondary immune thrombocytopenia, as for iron-deficiency anemia, also look for the cause of iron deficiency, including whether menstruation More, gastrointestinal lesions, etc. Only when the cause is found, the original disease is cured, and the cause of iron deficiency anemia is removed, will there be no relapse after iron supplementation treatment. So it is best to bring the original test data to the blood specialist to confirm the diagnosis. If the diagnosis is ITP and iron deficiency anemia, the current platelet is more than 30,000, the condition is not serious, iron deficiency anemia is easier to correct anemia, ITP treatment is the first choice for glucocorticoids, patients are very resistant to such drugs, and if platelets can Stable at more than 30,000, there is generally no obvious bleeding, you can observe no treatment, if you have bleeding symptoms, go to the hospital at any time; you can also intervene in traditional Chinese medicine treatment and conditioning, some patients can raise platelets, and let the platelet value stabilize , No longer soaring and falling. Finally, it should be emphasized that patients with thrombocytopenia not only need active treatment, but also pay attention to the care and diet in daily life. Do not do vigorous exercise to avoid bleeding caused by trauma; do not eat hard, coarse grain long fiber foods, because these foods are easy to cause gastrointestinal bleeding; also avoid colds and infections. Welcome to pay attention to the WeChat public account of thrombocytopenia patients: xxbjs75