Platelets under the microscope
|Classification and external resources|
Thrombocytopenia ou thrombocytopenia is to reduce the number of platelets No. blood, unlike what occurs in the thrombocytosis. When the amount of platelets in the blood is less than 150.000 / mm³, the individual is said to have thrombocytopenia. Patients with thrombocytopenia are more prone to hemorrhagic phenomena (bleeding), depending on the cause of thrombocytopenia and the total number of platelets.
In my case, the editor of the case has made a deep and lengthy assessment of whether I could be a person with thrombocytosis, since since 2005 I have suffered more than ten episodes of thrombophlebitis (clotted veins) in my legs. and in the arms, which is not so common… After months between hematologists and vascular surgeons everything was inconclusive and, given that the simple positive serology for HIV is a critical factor in the production of cerebrovascular accident (CVA) we talked and it was decided to install a filter in the vena cava, to maximize the protection (maybe this may have already saved my life unexpectedly) and the maintenance of two injections of clexane, of 60 and 40 ml each, daily until the end of my days; IAZUL.
Causes of thrombocytopenia
Causes of thrombocytopenia:
- Reduction of platelet production by bone marrow: in cases of medullary aplasia, fibrosis, leukemia or infiltration by malignant cells, chemotherapy for cancer and congenital megakaryocytic hypoplasia. The lack of nutrients necessary for the development of platelets as dehydration, vitamin B12 deficiency, toxicity niacin (B3) or folic acid. The diagnosis can be made through the biopsy of bone marrow. In this regard, my situation is particularly lacking in attention, since I underwent a gastroplasty and the obtaining of nutrients and vitamins is compromised and I make replacement with products bought abroad, since the prices practiced in Brazil would be ridiculous if they were not extorsive.
- Increased splenic sequestration: Splenomegaly raises the amount of platelets trapped in the spleen, increasing the rate of platelet lysis, commonly caused by hypertension door, leukemia with splenic infiltration of cells splenic lymphoproliferation (Lymphoma) and still in the Gaucher disease.
- Increased platelet destruction: Platelet survival can be shortened due to abnormal vessels, vascular prostheses and thrombi of fibrins. As an example we can cite the thrombotic thrombocytopenic purpura, vasculitis, hemolytic-uremic syndrome, disseminated intravascular coagulation e heart prostheses. Some infectious diseases can also destroy platelets like Dengue, Lyme disease and various Bacteriemias e Viremias (Sepses).
- Side effect of medicines: Hundreds of remedies have a small risk of inducing spinal suppression of platelet production. These include: diuretics thiazides, estrogens, antihistamines, pantoprazole, interferon, sulfathiazole, novobiocin, p-aminosalicylate, sedative / hypnotic and anticonvulsants. Alpha-methyldopa, digitoxin, salts of gold and heparin may induce platelet immune formation of antigen-antibody complexes and activation of system complement. Heparin thrombocytopenia occurs in 1-3% of patients who receive this drug for more than a week. The use of low molecular weight heparin reduces the risk of developing thrombocytopenia.
Signals and symptons
They depend on the cause of thrombocytopenia and the platelet count. When the count is greater than 50,000 / mm3 there are usually no symptoms. The classic manifestation of symptomatic thrombocytopenia (smaller than 50,000 / mm3) is bleeding. THEmenstruation becomes more prolonged and bulky, nasal bleeding, gums and bruises with any blow.
Treatment depends on the cause and severity of the disease. The main treatment for thrombocytopenia is to eliminate the cause of the problem, which may mean changing medicines that cause thrombocytopenia, changing the diet, treating an infection, or using corticosteroids to inhibit responses autoimmune and inflammatory. O lithium carbonate or folate, can also be used to stimulate platelet bone marrow production.
- Fiebach, Nicholas H .; Barker, Lee Randol; Burton, John Russell; Zieve, Philip D. (2007). Principles of Ambulatory Medicine. Lippincott Williams & Wilkins. ISBN 9780781762274. Retrieved 2015-04-30.
- Houghton, Andrew R .; Gray, David (2010). Chamberlain's Symptoms and Signs in Clinical Medicine 13th Edition, An Introduction to Medical Diagnosis. CRC Press.
- Lawrence, Peter F .; Bell, Richard M .; Dayton, Merrill T. (2012). Essentials of General Surgery. Lippincott Williams & Wilkins. ISBN 9780781784955.