Hu Guisheng, Beijing Institute of Hematology: What caused you to have a sudden decrease in platelets?

Hu Guisheng assistant WeChat: dd326751 Article source: Transferred from WeChat public account [Hu Guisheng studio] As early as the junior high school biology textbook, we learned the importance of platelets to the human body. When the human body is injured and bleeding, if there is no platelet There will be more bleeding, and platelets mainly play a role in coagulation. Platelet reduction is very harmful to the human body. Thrombocytopenia is the most likely to cause human leukocytes, which can cause leukemia. The “platelets” in human blood contain approximately 100,000 to 300,000 platelets per cubic millimeter of blood in normal people. Its lifespan is 8 to 12 days on average. Due to various reasons, the platelet count results are lower than the lower limit of the reference value, that is, platelets cut back. If the thrombocytopenia is serious, it can cause a series of symptoms, such as nose bleeding, gum bleeding, oral mucosal bleeding, gastrointestinal bleeding, bleeding of menstrual blood, and hematuria. So what is the reason for the sudden reduction of platelets? 1. Thrombocytopenia is commonly seen in the following situations and diseases: (1) Platelet production disorders: such as aplastic anemia, leukemia, megaloblastic anemia, bone marrow fibrosis, radiation damage, etc.; (2) platelet destruction or excessive consumption: Primary thrombocytopenic purpura, systemic lupus erythematosus, malignant lymphoma, rubella, thrombocytopenia caused by drug allergy, disseminated intravascular coagulation, etc.; (3) abnormal platelet distribution: hypersplenism; (4) radiotherapy and Chemotherapy, etc.   Second, platelet disease is caused by a decrease in platelet count (thrombocytopenia) or dysfunction (platelet insufficiency) resulting in poor hemostatic thrombosis and bleeding. The number of platelets is below the normal range of 140,000~400,000/μl. Thrombocytopenia may result from insufficient platelet production, retention of platelets by the spleen, increased destruction or utilization of platelets, and dilution. Severe thrombocytopenia due to any cause can cause typical bleeding: multiple ecchymosis, most commonly in the lower leg; or small sporadic ecchymosis at the site of minor trauma; mucosal bleeding (nasal bleeding, stomach Intestinal and urogenital tract and vaginal bleeding); and massive bleeding after surgery. Massive gastrointestinal bleeding and bleeding in the central nervous system can be life-threatening. However, thrombocytopenia will not be secondary to coagulopathy. 3. The spleen palpation of patients with thrombocytopenia due to increased platelet destruction (such as idiopathic thrombocytopenic purpura, drug-related immune thrombocytopenia, thrombotic thrombocytopenic purpura); and The spleens of thrombocytopenia patients secondary to platelet retention by the spleen are mostly palpable, as are thrombocytopenia patients secondary to lymphoma or myeloproliferative diseases.

Beijing Academy of Hematology Xie Bielu: What causes you to have a sudden decrease in platelets?

Xiebeilu studio WeChat add369456 As early as in the junior high school biology textbook, we have learned the importance of platelets to the human body. When the human body is injured and bleeding, if there is no platelet, the person will bleed continuously, and the platelet mainly plays the role of coagulation. Thrombocytopenia is very harmful to the human body. Thrombocytopenia is the most likely cause of human leukocytes, which can cause leukemia. The “platelets” in human blood contain approximately 100,000 to 300,000 platelets per cubic millimeter of blood in normal people. Its lifespan is 8 to 12 days on average. Due to various reasons, the platelet count results are lower than the lower limit of the reference value, that is, platelets cut back. If the thrombocytopenia is serious, it can cause a series of symptoms, such as nose bleeding, gum bleeding, oral mucosal bleeding, gastrointestinal bleeding, bleeding of menstrual blood, and hematuria. So what is the reason for the sudden reduction of platelets? 1. Thrombocytopenia is commonly seen in the following situations and diseases: (1) Platelet production disorders: such as aplastic anemia, leukemia, megaloblastic anemia, bone marrow fibrosis, radiation damage, etc.; (2) platelet destruction or excessive consumption: Primary thrombocytopenic purpura, systemic lupus erythematosus, malignant lymphoma, rubella, thrombocytopenia caused by drug allergy, disseminated intravascular coagulation, etc.; (3) abnormal platelet distribution: hypersplenism; (4) radiotherapy and Chemotherapy, etc.   Second, platelet disease is caused by a decrease in platelet count (thrombocytopenia) or dysfunction (platelet insufficiency) resulting in poor hemostatic thrombosis and bleeding. The number of platelets is below the normal range of 140,000~400,000/μl. Thrombocytopenia may result from insufficient platelet production, retention of platelets by the spleen, increased destruction or utilization of platelets, and dilution. Severe thrombocytopenia due to any cause can cause typical bleeding: multiple ecchymosis, most commonly in the lower leg; or small sporadic ecchymosis at the site of minor trauma; mucosal bleeding (nasal bleeding, stomach Intestinal and urogenital tract and vaginal bleeding); and massive bleeding after surgery. Massive gastrointestinal bleeding and bleeding in the central nervous system can be life-threatening. However, thrombocytopenia will not be secondary to coagulopathy. 3. The spleen palpation of patients with thrombocytopenia due to increased platelet destruction (such as idiopathic thrombocytopenic purpura, drug-related immune thrombocytopenia, thrombotic thrombocytopenic purpura); and The spleens of thrombocytopenia patients secondary to platelet retention by the spleen are mostly palpable, as are thrombocytopenia patients secondary to lymphoma or myeloproliferative diseases.

Beijing Academy of Hematology Xie Bielu: Will platelet increase be caused by inflammation?

Xiebeilu studio WeChat add369456 Platelets are very important substances in the blood, its role is very large, it is an effective substance to prevent serious bleeding from the wound. Once the wound is bleeding heavily, platelets can play the role of coagulation, block the wound, prevent excessive blood loss . The content of platelets in the blood has a certain reasonable range, too high or too low will affect health.  When the body’s resistance and immunity decline, it is prone to inflammatory diseases. Especially chronic inflammation, this kind of disease usually does not make people have obvious symptoms, so it will ignore such disease problems. There are many symptoms of chronic inflammation. For example, the nose often bleeds and the blood circulation is not smooth. The frequent occurrence of fever and cold is also caused by chronic inflammation. So does chronic inflammation cause platelet elevation?   Platelet hyperplasia is a myeloproliferative disease, which is characterized by bleeding tendency and thrombosis, peripheral blood platelets continue to increase significantly, the function is not normal, and bone marrow megakaryocytes proliferate excessively. Because the disease often has repeated bleeding, it is also called hemorrhagic thrombocytosis, and the incidence is not high. It is more common in people over 40 years old. Platelets are exfoliated from the cytoplasm of mature meganucleus in bone marrow. They are diverse in shape, inconsistent in size, easy to adhere, aggregate and destroy. They are very important in forming white platelet plugs, releasing platelet factors, and promoting blood clotting and blood clot contraction. The significance of is one of the important indicators for the study of hemostasis and coagulation disorders. Platelets are one of the coagulation factors. If the platelets are much higher than normal, it is a pathological manifestation. If the increase in platelets is accompanied by an increase in white blood cells, and the content of anticoagulant factors decreases, the blood viscosity increases or the blood flow decreases. Wait slowly. This may be a pre-thrombotic state. If it is the state mentioned in the appeal, you need to go to the hospital in time, because the pre-thrombotic state is only a manifestation of the disease. It can be inherited or acquired. of. The common causes of thrombocytosis are mainly the following:    1. Reactive thrombocytosis is found in infections, post-surgery, malignant tumors, post-splenectomy, acute blood loss or iron deficiency, trauma, non-infectious inflammation, etc. These causes lead to platelet-promoting Increased release of growth factors (such as thrombopoietin, interleukin-6) leads to increased platelets.   2. Spontaneous thrombocytosis    is seen in myeloproliferative diseases, such as polycythemia vera and early myelofibrosis, chronic myeloid leukemia, etc.   3. Primary thrombocytosis    Pathogenesis may be related to thrombopoietin and thrombopoietin receptor changes and downstream pathway activation. 50% of patients with primary thrombocythemia have JAK2V617F gene mutation, 3% to 5% of patients have MPL gene mutation, and 15% to 25% of patients have CALR gene mutation.

Shi Shurong Medical Talk: Case Sharing-How does an eight year old patient with thrombocytopenia recover?

Idiopathic thrombocytopenic purpura (ITP) is one of the most common hemorrhagic diseases in childhood. Many patients will take hormonal drugs to increase the platelet value when they are diagnosed, but the value rises quickly and falls quickly, and the hormone drugs There are also great side effects for pediatric patients. Director Shi Shurong’s WeChat consultation platform: zkxk9999 Patient: He Mou, boy, 8 years old, Shanxi people Course of disease: more than 1 year of suffering from thrombocytopenia: The patient found lower extremity bleeding spots, skin purple spots, oral blood bubbles in February 2012, after local treatment Unsuccessful; transferred to a local city hospital for testing, platelet 10, bone puncture confirmed ITP after hospitalization, and given hormone therapy; after discharge, hormone maintenance therapy was continued, and then platelet dropped to about 30,000 in January 2013, and then transferred to the city hospital for treatment There is no improvement; at the same time, due to the child’s long-term use of hormones, obesity, repeated hospitalization and restrictions on the child’s activities, this eight-year-old boy has an introverted personality. Treatment: The patient was transferred to Beijing for treatment in March 2013. Blood routine tests showed: WBC8.5, Hb121g/L, PLT28. The expert team conducted a detailed analysis of the child’s condition and established a combination of traditional Chinese and Western medicine in combination with the original treatment. Treatment plan, combined with traditional Chinese medicine conditioning after discharge. After being discharged from the hospital, the patient insisted on taking Chinese medicine for half a year, and the platelet value was rechecked within the normal range. Life and study were not affected. Following the follow-up, the patient He Mou still insists on a routine blood test about half a year, the platelet values ​​are within the normal reference range, and there is no sign of recurrence of colds. Blood disease experts reminded that children with thrombocytopenia need to increase the platelet value as soon as possible when the value is severely reduced in the acute stage to avoid serious bleeding symptoms. However, it is not recommended to use hormonal drugs for a long time, because side effects can easily affect the growth and development of children, and it is recommended to intervene in Chinese medicine as soon as possible. More patient communication help can pay attention to the WeChat public account: Thrombocytopenia Patient Association

Xie Bielu medical words: It is good to eat peanuts, especially for patients with thrombocytopenia!

Peanuts are very common ingredients in daily life, not only to nourish and nourish blood. Peanut clothing can also inhibit the dissolution of fibrin, increase the content of platelets, improve the quality of platelets, improve the defects of coagulation factors, and strengthen the contractile function of capillaries. So it has a certain effect on improving various bleeding diseases. Director Shi Shurong’s WeChat consultation platform: zkxk9999 experts said that eating peanuts often is good for patients with thrombocytopenia! Peanuts contain unsaturated fatty acids, which have the function of lowering blood lipids and serum cholesterol, can reduce the risk of coronary heart disease, prevent platelet aggregation, and prevent thrombosis. Peanut also has a good nourishing and nourishing effect on patients with thrombocytopenia. Patients with thrombocytopenia can often consume the following three peanut nourishing soups: peanut red dates and blood soup ingredients: 100 grams of peanuts, 50 grams of dried red dates, and an appropriate amount of brown sugar. Method: Peanuts are soaked in warm water for half an hour; dried red dates are washed with warm water and bubbly; red dates and peanuts are placed in an aluminum pot together, pour peanut water, add the appropriate amount of water, fry for half an hour, add the appropriate amount of brown sugar to make. Peanut white fungus lotus seed soup material: half white fungus, lotus seed 1, two peanuts two two, lily one two, crystal sugar. Practice: Wash the white fungus, lotus seeds, peanuts, and lilies, soak them overnight; put the soaked materials in an electric pressure cooker, add the appropriate amount of water, and pressurize for 20 minutes; add the right amount of crystal sugar after opening the cover . Peanut and longan soup ingredients: longan meat 30 grams, red clothing peanuts 100 grams, a little refined salt, a spoonful of brown sugar. Method: Wash the longan meat and red peanuts; boil the water in the pot, add the longan meat and peanuts; cook for about 8 minutes, add a bowl of cold water; cook for about 4 minutes, add the salt and brown sugar and mix well; can. In addition, peanuts can promote bone marrow hematopoiesis, which is good for patients with hematological diseases, especially for patients with anemia, thrombocytopenia, subcutaneous hemorrhage of purpura, and aplastic anemia. Peanuts are a good food therapy with many benefits. More patient communication help can pay attention to the WeChat public account: Thrombocytopenia Patient Association

Patients with thrombocytopenia: how to stop hormones to be safe?

The effect of hormone therapy on ITP is significantly obvious, but due to the effects of toxic and side effects and dependence, it is not possible to take it for a long time. It needs to be gradually stopped. Two points to be aware of when stopping the drug are: 1. Monitor the platelet count and observe the decline of platelet Running track and degree of descent. 2. As long as there is no worsening bleeding tendency, no active bleeding or fresh bleeding, the hormone dosage should be reduced according to the plan. How is it safe to stop taking hormones? Look at the sharing of this thrombocytopenic purpura patient to enter the first stage: Week 1 ~ 5 capsules of prednisone (25 mg)-4 capsules per week (20 mg); Week 2 ~ 3 capsules of prednisone ( 15 mg); Week 3 ~ Prednisone 2.5 capsules (12.5 mg) Week 4 ~ Prednisone 2 capsules (10 mg) Week 5 ~ Prednisone 1.5 capsules (7.5 mg) Enter the second stage: 6th Week / Week 7 ~ Prednisone 1 capsule (5 mg) Week 8 / Week 9 ~ Prednisone 0.5 capsule (2.5 mg) At the end of the hormone reduction, you need to find a targeted Chinese medicine to consolidate. Only then can the drug be completely stopped to prevent subsequent relapse. If you have any questions about this article or the disease, please feel free to follow us on WeChat and search more: xxbjs1

Shi Shurong Medical Talk: How to judge the severity of the diagnosis of thrombocytosis?

Primary thrombocythemia is a myeloproliferative disease, but the disease progresses slowly or even hidden in the early stage of the disease, and it cannot be discovered in time. However, as the disease progresses, some patients will develop acute leukemia. Director Shi Shurong’s WeChat consultation platform: zkxk9999 hemorrhage and thrombosis are the main complications and hazards of thrombocytosis, which directly affects the life expectancy and quality of life of patients. However, primary thrombocytosis often develops into a chronic process, and its severity is also different: high risk : Age &gt. 60 years old or ET-related thrombosis, bleeding or platelets &gt. 1500×109/L Medium risk: age 40-60 years old, no high risk factors Low risk: age &lt. 40 years old, no high risk factors and treatment of primary The purpose of thrombocythemia is to reduce the occurrence of complications. Therefore, the following treatment methods are common: -ET patients should be screened for hypertension, hyperlipidemia, diabetes, and smoking history, and treated accordingly. -All patients with ET should be given aspirin unless there are contraindications. -The purpose of treatment is to restore the number of platelets to normal. -Reducing cell therapy is needed in the high-risk group. The first-line treatment is hydroxyurea + aspirin. Young or pregnant patients choose interferon therapy. -In the low- and medium-risk group, in clinical trials or symptomatic ET patients (progressive splenomegaly, or severe microvascular symptoms, aspirin cannot be improved, or uncontrolled bleeding due to increased platelet count), cell reduction therapy is performed. -Patients with uncontrollable cardiovascular risk factors consider cell-reducing therapy. Although the above treatments for thrombocytosis have a certain effect, they also have the problem that the limitation of the effect is easy to repeat. In particular, chemotherapy drugs often require long-term application, and their side effects are inevitable. Therefore, it is necessary for patients to combine Chinese medicine Differentiation and treatment, increase efficacy and reduce toxicity. More patient exchanges and help can pay attention to WeChat public account: Thrombocytosis Patient Association

Shi Shurong’s consultation appointment: Why does the cold also aggravate the condition of thrombocytopenia?

Summer is here, the weather is hot, many people need to turn on the air conditioner to cool down, and the temperature difference between indoor and outdoor is too big, easy to cause a cold. Some patients with low platelet values ​​should pay attention to protection against cold infection. Director Shi Shurong’s WeChat consultation platform: zkxk9999 If a patient with thrombocytopenia has a cold, it is likely to aggravate the condition of thrombocytopenia, and the continuous reduction of platelet value will make the patient more likely to bleed. Viral infection is one of the key factors inducing the occurrence or aggravation of thrombocytopenia, especially in patients with acute thrombocytopenic purpura. Acute upper respiratory tract infection or other predisposing factors often occur 1 to 3 weeks before the onset of the disease. Viral infection is a common factor. Various viruses have been found to be involved in the pathogenesis of ITP, including herpes viruses, human parvovirus B19, measles virus, mumps virus, rubella virus, and hepatitis virus. The reason why the cold will aggravate the condition of thrombocytopenia is mainly manifested in the following aspects: ① The viral antigen is adsorbed on the surface of the platelet, binds with the corresponding antibody, forms an immune complex, and deposits on platelets and megakaryocytes, causing platelet destruction , Shortened platelet life. ②The virus can change the structure of platelet membrane glycoprotein, make its antigenicity change, and form autoantibodies to destroy platelets. ③ Antiviral antibodies cross-react with platelet surface glycoproteins, activating the complement system and causing platelet destruction. Virus may directly act on megakaryocytes to form nuclear viral inclusion bodies, resulting in reduced platelet production. ④The cold will activate the monocyte-macrophage system in the body or enhance the activity of the activated monocyte-macrophage system. Due to the presence of platelet antibodies, the activated monocyte-macrophage system will accelerate the removal of the combined Antibodies to platelets cause a further increase in thrombocytopenia. Patients with thrombocytopenia should not think that they will not catch a cold in summer. If they blow air conditioning in summer or do not pay attention in rainy days, they will easily have cold symptoms, which will lead to the relapse or worsening of thrombocytopenia. Therefore, summer should also pay attention to prevent colds, while actively treating to increase the platelet value. More patient communication help can pay attention to the WeChat public account: Thrombocytopenia Patient Association

Shi Shurong’s Medical Talk: What should I do if hormones treat thrombocytopenia and the body is severely swollen?

Many patients who have just been diagnosed with thrombocytopenia, especially those with lower values, will be treated with hormonal drugs, but the rapid increase of hormonal drugs will also bring many side effects. How should patients respond? Director Shi Shurong consulted Ms. Qi, a patient on WeChat zkxk9999: I am 25 years old, and my physical examination found that the blood routine platelet value is only 26, but the body has no discomfort symptoms, no bleeding, and only a slight bump is prone to bruising. After a bone marrow aspiration examination, the bone marrow hematopoietic function was normal. The doctor gave oral hormone therapy. Later, the platelet rose to 85, but after using the hormone for a month, the body was severely swollen and I dared not eat it again. Excuse me, is there any good treatment? ? Hematologist: Thrombocytopenia is a relatively common benign disease. The cause of the disease involves autoimmune disorders. In short, the patient spontaneously produces an anti-platelet growth antibody that destroys platelet growth. Commonly used therapeutic drugs have certain side effects. The most common side effects of hormones are: centripetal obesity, gastric mucosal damage, hypertension and elevated blood glucose; blood product infusions are only short-term effective, and their side effects are minor, but there are infections related to blood transfusion-related diseases Risk; while the spleen is removed for treatment, the spleen is an important immune organ of the human body, and the ability to resist infection will be reduced after resection, which needs to be evaluated by a specialist clinic. At present, for the treatment of targeted thrombocytopenia, the timely intervention of Chinese medicine and traditional Chinese medicine has made more and more patients see a more obvious increase in platelets. At the same time, compared with hormone therapy, traditional Chinese medicine will not let patients be affected by side effects. At the same time, after the patient’s platelet lifts and stabilizes, the chance of recurrence is also greatly reduced. Because thrombocytopenia is mostly related to the imbalance of the patient’s autoimmune function, even if the patient recovers and the platelet returns to normal, it is necessary to pay close attention, regularly review the blood routine, and monitor the platelet value. To emphasize, the lower the platelet value, the higher the risk of bleeding. Therefore, regardless of bleeding symptoms, patients should be actively treated to increase the platelet value and avoid serious bleeding. In addition, cold infections are also likely to cause relapse or exacerbation of thrombocytopenia, pay attention to prevention in life. For more thrombocytopenia disease knowledge or patient help, please pay attention to WeChat public number: xxbjs75

Xie Bielu medical words: Patient question: How can thrombocytopenia no longer recur?

Thrombocytopenia is a common hemorrhagic disease, but some patients have a low value, but they are accidentally found due to a bleeding point caused by a cold, which confirms the diagnosis of thrombocytopenic purpura. How to treat this situation? Director Shi Shurong consulted with WeChat zkxk9999 Hebei patient Mr. Wang: I found a skin bleeding spot to go to the hospital for a cold and was diagnosed with idiopathic thrombocytopenic purpura. Bone marrow aspiration showed megakaryocyte maturation disorder. Blood routine examination of platelet value 9. 2016 3 He was admitted to the hospital on the 24th of the month. He was checked for platelet 122 on the 29th of the month. He was discharged from the hospital on May 27. PLT8 was admitted to the hospital again. Intravenous infusion of dexamethasone 40mg, medication for four days, prednisone suspension, platelets 41, 3 mg of prednisone orally to stop after stopping the meter, in conjunction with eating Chinese medicines for platelet ascending, such as platelet decline to continue a large dose shock. After that, the condition was repeated twice, and each time required hospitalization, which was expensive. I don’t know how to treat it, so that thrombocytopenic purpura will not recur? Hematologist: According to the data, the diagnosis of idiopathic thrombocytopenic purpura is clear. The disease is humoral immune-mediated destruction of platelets. The traditional treatment methods include: hormone, splenectomy and immunosuppressive therapy. From the point of view of platelet values, platelets can be elevated after hormone shock treatment, indicating that the hormone is still effective. However, when taking oral hormones, the reduction and withdrawal should not be too fast. At the same time, since the effects of hormone drugs on increasing platelet value are mostly temporary, in order to avoid the occurrence of side effects and improve the efficacy of hormones at the same time, it can be combined with traditional Chinese medicine and conditioning. At present, the treatment of thrombocytopenic purpura is mostly based on the combination of traditional Chinese medicine and western medicine. Traditional Chinese medicine uses medicine based on syndrome differentiation. Western medicine treatment can prevent patients from severe bleeding and avoid life worries. Complementary treatment of traditional Chinese medicine and western medicine can stabilize the patient’s condition. , No more. For more thrombocytopenia disease knowledge or patient help, please pay attention to WeChat public number: xxbjs75

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

Spleen resection is not the fundamental solution to hypersplenism

[Etiology]    hypersplenism can be divided into two major categories: primary and secondary:    (1) Primary hyperthyroidism is called primary splenic hyperplasia, non-tropical idiopathic splenomegaly, primary splenic Granulocytopenia, primary splenic pancytopenia, splenic anemia, or splenic thrombocytopenia. Because the etiology is unknown, it is difficult to determine whether the group&nbsp. disease&nbsp. is a different consequence caused by the same etiology or an independent disease that is not related to each other. (2) Secondary hypersplenism occurs when the following causes are clear: ① acute infection with splenomegaly, such as viral hepatitis or infectious mononucleosis. ② chronic infection, such as tuberculosis, brucellosis, Malaria, etc. ③Congestive splenomegaly is portal hypertension with internal obstruction (such as portal cirrhosis, cirrhosis after necrosis, biliary cirrhosis, hemosiderinosis, sarcoidosis, etc.) and Extrahepatic obstruction (external compression of portal vein or splenic vein or thrombosis), etc. ④ Inflammatory granuloma such as systemic lupus erythematosus, rheumatoid arthritis, Felty syndrome, and sarcoidosis. ⑤ Malignant tumors such as lymphoma , Leukemia and cancer metastasis. ⑥ Chronic hemolytic diseases such as hereditary spherical cell hyperplasia, autoimmune hemolytic anemia and marine anemia. ⑦ lipid deposits such as Gaucher disease and Niemann-Pick disease. ⑧ Myeloproliferative diseases such as polycythemia vera, chronic myeloid leukemia and myelofibrosis. ⑨ Others include splenic aneurysm and cavernous hemangioma.   (3) Concealed hypersplenism, no matter primary or secondary hypersplenism, due to the good compensatory hyperplasia of the bone marrow, peripheral blood shows no cytopenia. But once factors such as infection or drugs inhibit hematopoietic function, it can lead to single or pancytopenia.  【Therapeutic measures】  Removal of the spleen and X-ray radiotherapy cannot relieve the primary disease that causes hypersplenism. Therefore, the primary disease should be treated first. The indications for splenectomy are as follows:    1. Splenomegaly is significant, causing obvious symptoms of compression.   2. Severe anemia, especially when there is hemolytic anemia.   3. There is a considerable degree of thrombocytopenia and bleeding symptoms. If the platelet count is normal or slightly reduced, thrombocytosis may occur after spleen removal, and even thrombosis may occur, so those with normal or mildly reduced platelets should not cut the spleen.   4. Agranulocytosis, with a history of repeated infections.  Spleen patients should be fully prepared before surgery. If severe anemia is given blood transfusion, thrombocytopenia and bleeding should be treated with adrenal cortex hormones, and those with agranulocytosis should actively prevent infection.

Platelets have these four main effects on the human body, do you all know?

Platelets are an important part of blood cell production. The role in the human body is reflected in many aspects, and it is directly related to the necessity of the treatment of thrombocytopenia. The role of platelets in the human body is not small, and the low value cannot be ignored! Role 1: vasoconstriction platelets release vasoconstrictor substances through it, causing them to clump together to block damaged blood vessels and promote coagulation. Function 2: Platelets forming hemostatic plugs are easy to adhere and deposit on the collagen fibers exposed by the damaged blood vessels, and gather into clusters to form hemostatic plugs. The thrombus is directly blocked at the vascular split, in addition to the function of plugging, it can also be maintained The integrity of the blood vessel wall. Role 3: Coagulation releases substances that promote blood clotting, and accelerates the formation of blood clots at the rupture of blood vessels. Platelet factor Ⅲ provides phospholipid surface adsorption of most coagulation factors, increasing the rate of coagulation reaction. Role 4: The fibrin in the plasma releasing anti-fibrinolytic factor is easily degraded under the action of the fibrinolytic system. Because platelets contain anti-fibrinolytic factors and inhibit the activity of the fibrinolytic system, the formed blood clot will not collapse. Platelet count &lt.100×109/L is thrombocytopenia, which is usually thrombocytopenia caused by immunological imbalance/platelet damage, and major platelet production disorders, such as aplastic anemia, acute leukemia, acute radiation sickness, etc. . There have been many clinically dangerous events caused by low platelets, so once the value is found to be low, especially below the critical safety level, it needs to be highly valued! If you have any questions about this article or the disease, please feel free to follow us on WeChat and search more: xxbjs1

Do these points in life to effectively avoid relapse of thrombocytopenia!

Thrombocytopenia is a benign blood disease, as long as the treatment is rational and standardized, it is easy to increase the platelet value. But thrombocytopenia is also prone to repeated attacks. Patients often complain that the original values ​​have risen, but it hasn’t fallen again in a while. What can be done to prevent platelet recurrence? Director Shi Shurong consulted WeChat zkxk9999. For patients with thrombocytopenia, the rise and fall of platelet values ​​are affected by many factors. Among them, the most common are non-cold infections, diet, drugs, and other factors. Therefore, in daily life, patients with thrombocytopenia should pay attention to the following points: 1. The prevention of infections of various diseases is one of the main causes of thrombocytopenia. Various bacterial infections have led to the recurrence of thrombocytopenia. Normally, you should prevent colds, add clothes in cold weather, and reduce clothes in hot weather. If there are people with colds around, stay away from the infection. 2. Avoid trauma. Because the number of platelets in the patient’s blood has not yet returned to normal values, it is easy to cause blood flow due to a little trauma. 3. Pay attention to the reasonable arrangement of food intake in daily life. The food should be soft and easy to digest and absorb, so as not to cause gastrointestinal trauma and bleeding. In addition, you should avoid eating spicy spicy food, such as various spicy hot pot, spicy food and the like. 4. Pay attention to personal hygiene. Only by taking frequent showers and frequently changing underwear, etc. can you ensure clean and dry skin and avoid some skin diseases. At the same time, it is also necessary to cut nails frequently to minimize scratching of the skin to avoid infection. In addition, attention should be paid to the application of medicines: some medicines will affect the blood, and the attending doctor must be informed of his condition in a timely manner for any reason, to avoid the aggravation caused by improper medication. Such as: cold, fever, etc. For more thrombocytopenia disease knowledge or patient help, please pay attention to WeChat public number: xxbjs75

Why is thrombocytopenia complicated with liver disease, how to treat?

Among adult thrombocytopenia cases, it is more complicated than the pediatric disease group. It may be a combination of multiple diseases. In addition to the common immune thrombocytopenia, it may also be complicated by liver disease. Hepatitis B first, followed by thrombocytopenia-talk about the reasons and treatment There are four reasons for the cause: 1-Hepatitis virus damages hematopoietic stem cells, causing bone marrow damage or suppression, and the source cells that affect platelets in the bone marrow are megakaryocytes; 2-Hepatitis B 1. Splenomegaly caused by liver cirrhosis, which affects the excessive destruction of platelets in the spleen; 3-impaired liver function, resulting in reduced protein synthesis and reduced thrombopoietin; 4-hepatitis B accompanied by immune dysfunction, causing platelet-related immunoglobulin Increased, increased platelet destruction. Regarding the treatment of concomitant low platelet: if the clear hepatitis B virus load is increased, the anti-hepatitis B virus Western medicine has a reliable effect, and it can allow targeted Chinese medicine to participate. In the treatment sense, it may be more involved in other Chinese medicine diseases that Western medicine cannot solve. Conditioning. If the platelet cannot recover within a short period of time, or if there is a clear damp heat syndrome, blood stasis syndrome, and qi and blood deficiency syndrome, Chinese medicine can of course be used to differentiate the syndromes from these aspects, and it can be combined with western medicines against hepatitis B virus to a certain extent. Consolidate and stabilize the treatment effect. If you have any questions about this article or the disease, please feel free to follow us on WeChat and search more: xxbjs1

Shi Shurong’s medical words: Will thrombocytopenia be found before pregnancy, will it affect fertility?

Thrombocytopenia can occur at any age, including women of childbearing age. In order to have a high-quality baby during pregnancy and pregnancy, all the physical examinations will be carried out before pregnancy to ensure the health of the body. Then, will the discovery of thrombocytopenia affect pregnancy during pregnancy? Director Shi Shurong’s micro-signal zkxk9999 Ms. Wang, Hubei Consultation: I went to the hospital for a pre-pregnancy examination some time ago. The blood routine test results showed that the platelet value was very low. The doctor said that it does not rule out thrombocytopenia. If pregnant, it may have an impact. We are very anxious now. What impact does this disease have on children? Can you continue to conceive? Hematologist: I always see some women with thrombocytopenia asking: Will this disease affect fertility? The answer is yes. Because there are many possible diseases and complications caused by thrombocytopenia, it is best for patients to consider carefully, at least wait for the condition to stabilize, and then consider preparing for pregnancy after the platelet value reaches a safe value. Platelets are involved in the blood coagulation mechanism. Its number is reduced or its function is abnormal. Clinically, skin and mucous membrane bleeding is slightly visible, such as: bleeding points on the body, purpura, and ecchymosis. Heavier organ bleeding can be seen, the most common is gastrointestinal bleeding, and more severe intracranial bleeding is also life-threatening. In summary, the biggest hazard of thrombocytopenia is bleeding. For women of childbearing age, if they have thrombocytopenia and continue to conceive, they will not only hurt their bodies, but also cause harm to their children. Therefore, the inspection found that thrombocytopenia should be actively treated, as soon as possible to increase the platelet value, and wait for the body to recover before considering fertility. For more thrombocytopenia disease knowledge or patient help, please pay attention to WeChat public number: xxbjs75

Shi Shurong’s words: What should parents do if their child has thrombocytopenia?

It is common in children with immune thrombocytopenia (ITP), which is an autoimmune bleeding disorder. Due to the excessive destruction of platelets, resulting in decreased platelets. In addition, some children with blood diseases are also common because of chemotherapy-induced thrombocytopenia. Director Shi Shurong’s micro-signal zkxk9999 thrombocytopenia children need elaborate care from parents to reduce bleeding, so what should parents do? 1. Give nasal drops to children with nasal drops morning and evening to prevent nasal mucosa from drying; children are strictly forbidden to dig noses to prevent nasal bleeding. 2. Let the child develop the habit of defecation on time. If the stool is dry, you can take laxatives under the guidance of a doctor, such as fusong, lactulose, etc., to prevent dry stools from causing anal lacerations. 3. Avoid eating raw food, so as not to damage the oral cavity and gastrointestinal mucosa. 4. If the child has platelets ≤20×109/L or has anemia or high fever, he should rest in bed. Parents especially need to take care of the children to avoid accidentally falling from the bed. 5. Avoid children crying violently. 6. Pay attention to observe whether the color of the child’s urine is normal, and report to the doctor in time if abnormal. 7. Pay attention to observe the child’s mental consciousness. Once the child is found to be sleepy, irritable, and mentally insane, and the child is crying abnormally, report to the doctor in time. 8. If the big girl comes during the period of thrombocytopenia, she should inform the doctor. When thrombocytopenia, there will be obvious skin bleeding points or skin petechiae, then, the more skin bleeding points, the more dangerous? Generally speaking, when platelets ≤50×109/L, there will be skin bleeding spots on the body. Bleeding points on the skin are not life-threatening. Compared with skin bleeding points, nose bleeding, oral bleeding, gastrointestinal bleeding, intracranial bleeding, etc., bleeding in these places is dangerous and even fatal. All in all, for children with thrombocytopenia, parents should pay attention and find that thrombocytopenia takes timely treatment measures, the purpose of treatment is to increase the platelet value, control bleeding symptoms, reduce platelet damage, to ensure that patients do not risk from bleeding. For more thrombocytopenia disease knowledge or patient help, please pay attention to WeChat public number: xxbjs75

Examination found thrombocytopenia, need to understand these three aspects!

Clinically found that most patients with thrombocytopenic purpura are found by routine examination, or after trauma, it is difficult to stop bleeding. When blood routinely detects a decrease in platelet values, it is necessary to understand the following three aspects. Suddenly found that the platelet is too low, you must do these 3 points! First of all, as soon as you see a problem with thrombocytopenia or bleeding in your body, you need to go to a blood specialist in a regular hospital immediately. The doctor will first help you rule out whether it is pseudo thrombocytopenia, and patients with bleeding tendency need to be screened for the presence of abnormal blood clotting. Targeted medical treatment can better solve the problem of low platelet, and lay a good foundation for the premise. Secondly, if the examination is clearly thrombocytopenia, the patient needs to cooperate with the doctor to find out the cause of thrombocytopenia from two aspects. The first aspect is the reduction of platelet production: whether it is caused by certain factors, such as drugs, chemicals, malignant tumors, infections or ionizing radiation, etc. These factors will damage the hematopoietic function of the bone marrow. Older patients need to see if they exist Bone marrow failure diseases, such as myelodysplastic syndrome, aplastic anemia, and leukemia. The second aspect is excessive platelet destruction: mainly immune thrombocytopenia, due to the body’s immune dysfunction, producing antibodies against its own platelets, resulting in excessive platelet destruction, non-immune platelet destruction is too much, mostly diffuse Intravascular coagulation, thrombotic thrombocytopenic purpura, but it is generally rare. Finally, after selecting the treatment to confirm the diagnosis, the first thing to do is to carry out the treatment based on the platelet value (the primary disease has primary disease treatment). Some patients with platelets that are in the safe range and have no bleeding symptoms can be observed and reviewed, and they can be left untreated. However, for patients with platelets lower than 60, intervention therapy is necessary: ​​because the platelet value is susceptible to fluctuations caused by external factors when the disease is not recovering, individual patients may even decline sharply, especially those with bleeding tendency. Treatment ideas are simply divided into: 1. Simple Western Medicine, 2. Simple Traditional Chinese Medicine, 3. Integrated Chinese and Western Medicine. The purpose is to restore the normal production board function and the normal immune system (most ITP patients have immune imbalance disorders). If you have any questions about this article or the disease, please feel free to follow us on WeChat and search more: xxbjs1

Shi Shurong medical words: I heard that thrombocytosis is very harmful, how to treat it?

Primary thrombocythemia is a myeloproliferative disease. The disease progresses slowly in the early stage of the disease, and the hidden symptoms are not easy to be found. With the development of the disease, the symptoms will be further aggravated, and even transformed into acute leukemia, the treatment is more difficult, and it is more harmful to the body! Director Shi Shurong’s WeChat signal zkxk9999 The middle-aged and elderly population is the main incidence group of thrombocytosis. The initial symptoms are atypical and do not even have any sensation, but with the abnormal increase of platelet values, patients will have serious bleeding or thrombosis hazards. Therefore, thrombocytopenia seriously jeopardizes the patient’s health, even lifespan, and requires treatment. Primary thrombocytosis is a myeloproliferative disease that occurs in bone marrow stem cells. Secondary thrombocytosis is commonly caused by inflammation and neoplastic diseases. Symptoms such as fatigue, bleeding, anemia, numbness of hands and feet, and splenomegaly are common clinical manifestations in the early stages of thrombocytosis. How to treat thrombocytosis? Most patients or hospitals use oral hydroxyurea or intramuscular injection of interferon for long-term maintenance treatment after diagnosis of bone penetration or genetic testing. When the platelet rises in an uncontrollable state, it will increase hydroxyurea or other drugs to suppress bone marrow. . During medication, the platelet values ​​are well controlled, but the side effects of these drugs are ignored. Chemotherapy drugs have always been called “double-edged swords”. While reducing abnormal blood cells, they will also produce adverse reactions to the body’s normal functions. In fact, although these drugs have a certain effect, they cannot prevent the progress of the disease. Therefore, hematological experts recommend that patients can cooperate with targeted traditional Chinese medicine syndrome differentiation treatment while effectively controlling the disease, effectively controlling platelets, and reducing the number of The occurrence of various complications. For more knowledge about thrombocytosis disease or patient help, please pay attention to WeChat public number: xxbzd999

Shi Shurong’s Medical Talk: Do you understand the seven hazards of thrombocytopenia?

As we all know, the main role of platelets in the human body is to stop bleeding and coagulate. Then, if the platelet is reduced and the body’s blood coagulation function is abnormal, there may be a phenomenon of endless bleeding. In addition, there are other hazards that can cause problems for patients. Director Shi Shurong’s micro-signal zkxk9999 about some of the harmful manifestations of thrombocytopenia, the following are listed for you: Hazard 1: Thrombocytopenic purpura is characterized by a significant reduction in platelets, accompanied by skin and mucous membrane purpura, severe cases may have bleeding in other parts such as nose Bleeding, bleeding gums, excessive menstrual bleeding or severe vomiting, hemoptysis, blood in the stool, hematuria and other symptoms, and intracranial hemorrhage are the cause of death. Hazard 2: Haemorrhage after surgery; Hazard 3: Multiple petechiae and purpura common in both lower extremities; Hazard 4: Cause gastrointestinal hemorrhage and central nervous system hemorrhage, or even pose a life threat; Hazard 5: Sudden onset, often accompanied by Fever. High fever is one of the most common symptoms of thrombocytopenia. Decreased platelets in the blood will make the patient’s own immune system decline, resulting in various infections and fever symptoms. Hazard Six: Acute thrombocytopenia is mostly children under 10 years of age. Acute thrombocytopenia is mostly children under 10 years old. There is a history of viral infection before the disease. The above respiratory tract infections, rubella, measles, and chickenpox are most common; they can also be after vaccination. The incubation period between infection and purpura is mostly within 1-3 weeks. It is mainly skin and mucous membrane bleeding, which is often serious. The skin bleeding is petechiae of different sizes, unevenly distributed, and most of the limbs. Mucosal hemorrhage includes epistaxis, bleeding gums, and blisters from the oral mucosa. There are often gastrointestinal and urinary tract bleeding, subconjunctival hemorrhage, and a few retinal bleeding. Spinal cord or intracranial hemorrhage is common and can cause paralysis of the lower extremities or intracranial hypertension, which can be life-threatening. Hazard Seven: Chronic thrombocytopenia The most common chronic thrombocytopenia accounts for 80% of primary thrombocytopenic purpura, mostly 10-40 years old, and women are 3-4 times that of men. Onset attack. Patients may have persistent bleeding or repeated attacks, and some may show local bleeding tendency, such as repeated nosebleeds or excessive menstruation. Petechiae or ecchymosis can occur on the skin and mucous membranes of any part, but the distal limbs are more common. This shows that the harm caused by thrombocytopenia may be fatal. Therefore, do not ignore the treatment because there are no obvious symptoms. If you find that thrombocytopenia must choose a suitable treatment method according to your own situation, increase the value as soon as possible to avoid serious bleeding. More thrombocytopenia disease knowledge or patient help can pay attention to WeChat public number: xxbjs75