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Why platelet count decreases in blood - causes of thrombocytopenia

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  • How to reduce platelets in the blood
  • How to increase platelet count in the blood
  • How to get rid of blood clots
  • - drugs with acetylsalicylic acid,
  • - cranberry juice,
  • - green tea, ginger root, cinnamon,
  • - Orange juice.

What is thrombocytopenia?

Platelets - These are enucleated blood cells that are produced in the bone marrow by differentiation of stem cells.

Platelet challenge - participation in the process of blood coagulation. If there is bleeding or damage to the vessel, the platelets come together, forming a kind of cork that plugs the damage and, at the same time, secrete substances that contribute to coagulation.

For this reason, a small number of platelets is accompanied by bleeding and permanent bruising. Note that bleeding becomes frequent only if the platelet count is less than 20,000-30000 cells per milliliter of blood. And they become permanent if the platelet count is less than 10,000 units per milliliter. In these situations, bleeding appears even without injury.

Based on these findings, several degrees of thrombocytopenia are distinguished:

  • Soft. If the platelet count per milliliter is from 100,000 to 150,000.
  • Average. If between 50,000 and 100,000.
  • Heavy. If the platelet count is between 10,000 and 50,000.
  • Therapeutic, requiring immediate blood transfusion. If less than 10000.

Classification

Low platelets in the blood may differ depending on the mechanism of the formation of the disorder. Thrombocytopenia happens:

  • alloimmune - a consequence of the destruction of small blood platelets due to the incompatibility of different blood groups,
  • autoimmune - the body perceives such particles as a foreign element and produces specific antibodies against them,
  • transimmune - blood antibodies penetrate the fetus through the placenta of the mother,
  • heteroimmune - is associated with the appearance of antigens or viruses in the blood.

Symptomatology

A reduced platelet count may be asymptomatic, but this is only possible with a slight deviation from the norm. Otherwise, there are characteristic clinical manifestations:

  • frequent nosebleeds
  • conjunctival hemorrhage,
  • increased bleeding gums
  • prolonged hemorrhages that develop even after minor injuries,
  • bruising after minor trauma,
  • the formation of large hematomas with slight bruises,
  • small multiple hemorrhages on the skin that take the form of a rash or may merge into large spots,
  • heavy menstruation in women.

All symptoms of the disorder are expressed as bleeding disorders. If the platelets are below normal, they cease to fully fulfill their main role - to form blood clots, acting as a “blockage” of damaged vessels.

Diagnostics

If one or more clinical manifestations occurs, you must go to a medical institution as soon as possible in order to pass a general blood test.

The sampling of the test fluid is carried out from the finger, less often venous blood is required, and the hematologist is responsible for decoding the results. To obtain the most reliable information, it is recommended to conduct a study on an empty stomach and in the morning.

Such a laboratory test is not enough to identify the reasons why there are low platelets in the blood. So that the doctor can establish the etiological factor, patients need to undergo a comprehensive examination.

Common primary diagnosis for all includes:

  • collection and analysis of anamnesis - information regarding the course of pregnancy, addiction to bad habits and taking medications, finding the cause of the development of anomalies,
  • thorough physical examination of the patient,
  • assessment of the condition of the skin and eyes,
  • a detailed survey of the patient - to find out the intensity of the symptoms and the time of their first manifestation.

Additional laboratory tests, instrumental procedures and consultations of doctors of a different profile are assigned individually.

You can completely get rid of the problem by eliminating the main etiological factor. Sometimes it’s enough to refuse to take certain drugs, completely eliminate bad habits. However, often an integrated approach is required to neutralize the pathological trigger.

You can raise platelets in the blood of a newborn with the following actions:

  • donor milk, which is given for a month - after that, mother’s milk is gradually introduced into the diet with constant monitoring of laboratory parameters,
  • intravenous administration of 2 milligrams of prednisone per 1 kilogram of body weight - the course of therapy is 2 weeks,
  • transfusion of donor platelet mass,
  • the introduction of immunoglobulins,
  • intake of rutin and ascorbic acid.

Treatment in older children:

  • immunoglobulin in the amount of 1,500 milligrams per 1 kilogram - give 1 time for 2 days,
  • the use of glucocorticosteroids,
  • sodium ethamylate - 1 milliliter 1 time per day for 10 days,
  • calcium pantothenate,
  • replacement transfusion of thromboconcentrate blood components with preliminary plasma irradiation.

If there is a decrease in platelet blood in adults, the treatment regimen will be as follows:

  • immunoglobulin injections
  • taking glucocorticosteroids,
  • platelet transfusion,
  • use of anti-Rhesus D-serum.

All patients are prescribed vitamin-mineral complexes, immunomodulators, enrichment of the menu with omega-3 fatty acids, physiotherapy exercises and dosed physical exercises.

It is possible to quickly increase the platelet concentration by folk remedies, but this should be done after prior consultation with the attending physician. At home, medicinal decoctions and infusions are prepared on the basis of such components:

  • nettle,
  • sesame seeds
  • rose hip
  • chamomile,
  • chokeberry,
  • Oak bark.

Possible complications

If the problem of reduced platelets is ignored, then the likelihood of developing undesirable complications is high. These include:

  • extensive internal bleeding
  • acute cerebral hemorrhage,
  • severe blood loss
  • stroke,
  • retinal hemorrhage, which can lead to loss of vision.

All violations can be fatal.

Prevention and prognosis

So that a person does not have a problem with the fact that platelets in the blood are lowered, it is necessary to strictly observe several simple rules. Prevention includes the following actions:

  • rejection of bad habits,
  • healthy and nutritious nutrition,
  • continuous strengthening of immunity,
  • taking medications only as prescribed by a specialist,
  • streamlining the daily routine
  • active lifestyle
  • regular medical examination and a complete blood count.

The prognosis fully depends on the etiological factor. In any situation where the platelets are lowered, the absence of treatment causes either negative consequences or complications of the underlying disease.

Possible causes of low platelet count

Different types of thrombocytopenia are classified depending on the cause of the occurrence, and therefore, 5 groups are distinguished:

Thrombocytopenia due to lack of production of megakaryocyte. This type includes all thrombocytopenia that has developed due to poor production of megakaryocytes, that is, the cells from which platelets are formed. This group of thrombocytopenia in all cases is associated with anemia and / or leukopenia, leukocytosis (an increase in the number of lymphocytes).

The most common pathologies that determine this type of thrombocytopenia are:

  • Bone marrow tumors. Such as acute myeloid leukemia, acute lymphoblastic leukemia, multiple myeloma.
  • Brain tumor infiltration. Lymphoma and carcinoma.
  • Bone marrow aplasia. Disruption of stem cell production caused by functional depletion of bone marrow. The violation can affect not only megakaryocytes, but also all other cell lines. May be caused by congenital diseases such as Fanconi anemia or acquired viral infections such as mononucleosis, chicken pox, rubella, as well as bacterial, or as a result of chemical agents such as alcohol or estrogen, or physical agents such as ionizing radiation.

Thrombocytopenia deficiency. The bone marrow produces a physiologically sufficient number of megakaryocytes, but they form an insufficient number of platelets. It is characterized by a normal or even elevated level of megakaryocytes, the average life expectancy of platelets is 10 days. All thrombocytopenia of this group are accompanied by anemia and / or leukopenia.

The reasons that determine these thrombocytopenia are:

  • Vitamin B12 and Folic Acid Deficiency. Deficiency of vitamin B12 and folic acid determine the synthesis of altered tissue DNA with a high proliferation rate, such as bone marrow.
  • Hereditary Thrombocytopenia. It is caused by genetic mutations that are transmitted in a dominant or recessive way. In the first case, it is enough to inherit only one of the mutated genes for the development of the disease. In the second, you need to get the gene from both parents. Not always a birth defect manifests itself from the first years of life, but it will certainly manifest itself with age.

Thrombocytopenia due to accelerated platelet destruction. In this case, an increased level of megakaryocytes is detected, but the average platelet life is significantly reduced below the physiological 10 days, platelet replacement is accelerated, but sometimes it remains normal or reduced. This type of thrombocytopenia occurs, as a rule, without any other clinical manifestations.

Possible causes include:

  • Immune Thrombocytopenic Purpura. An acquired autoimmune disease is characterized by a lack of platelets due to their destruction in the bone marrow. The reason is unknown.
  • Bernard-Soulier Syndrome. A set of genetic diseases associated with von Willebrand factor receptor disorders. This factor binds to the platelet membrane and allows them to attach to the tissue of damaged vessels.

Thrombocytopeniafrom excessive use of platelets. The number of megakaryocytes is normal, the average life expectancy of platelets is less than or about ten days, and accelerated platelet synthesis. It is accompanied by anemia, abnormal physiological processes of stopping bleeding (hemostasis), kidney problems.

The most common causes:

  • Thrombotic Thrombocytopenic Purpura. Suddenly, small clots form in all blood vessels of the body, which consumes a large number of platelets, which leads to their deficiency. The reasons are unknown.
  • Scattered intravascular coagulation. A serious disease in which a large number of blood clots form in the vessels. This is due to the activation of tissue coagulation factor.
  • Hemoremic syndrome. The combination of symptoms that affect the blood and kidneys, and is characterized by the simultaneous presence of hemolytic anemia (low hemoglobin due to excessive destruction of red blood cells), thrombocytopenia and acute renal failure (impaired renal function with increased blood urea and creatinine). It can be caused by a bacterial infection and certain types of drug therapy, such as chemotherapy and, in particular, the use of mitomycin. It is also often observed in pregnant women, after pregnancy, and in newborns.

Thrombocytopenia with platelet capture from the bloodstream. It is characterized by a normal level of megakaryocytes or an increased, average platelet life expectancy, normal replacement rate. With thrombocytopenia of this class, the presence of anemia, hemostasis problems, renal failure, and neurological problems are simultaneously detected.

The most common causes are:

  • Splenomegaly. An increase in the spleen as a result of various diseases. The increase leads to the absorption of platelets from the bloodstream. There are many causes of splenomegaly: infections (hepatitis, mononucleosis, brucellosis, tuberculosis, syphilis, malaria, etc.), anemia (thalassemia, sickle cell anemia, etc.), accumulation diseases (a set of diseases characterized by accumulation of metabolic products in cells), cancer blood (lymphoma, leukemia, etc.) and a number of other reasons.

Symptoms of Thrombocytopenia

Often the disease is present in mild or moderate form, or completely asymptomatic. When symptoms are present, they can be summarized as follows:

  • Purpura. Stains of cinnabar color of various sizes, randomly scattered across the skin. The size, as I said, is variable, but more than 3 mm, otherwise they can be called petechiae.
  • Blood from the nose.
  • Hematomas.
  • Bleeding. They can be localized in various parts of the body: gums, urinary tract, gastrointestinal tract. Very rarely, fortunately, cerebral hemorrhages can be observed.
  • Exudation in the joints.

What to do if your platelet count is low

In all patients with abnormal bleeding and bruising, he analyzes the platelet count and a general blood test.

Often, in the absence of symptoms, thrombocytopenia is detected by chance, performing blood tests for other reasons. Since, as we have seen, thrombocytopenia can be the result of a large number of diseases, an accurate diagnosis is necessary, which is important for subsequent proper treatment.

How is thrombocytopenia diagnosed?

Some symptoms may help. determine the cause of thrombocytopeniafor example, an elevated temperature indicates an infectious etiology, an increase in the size of the spleen indicates thrombocytopenia due to splenomegaly, the presence of urea and creatinine in the urine indicates a decrease in renal function, but in any case, in addition to the aforementioned blood test, it is often required to correctly diagnose additional examinations, such as:

  • Complete blood count. In particular, a general blood test with an assessment of the levels of leukocytes, red blood cells and platelets, definitions: MCV (erythrocyte volume 9), MCH (average hemoglobin content), MCHC (average concentration of hemoglobin in red blood cells), RDW (red blood cell uniformity).
  • Bone Marrow Biopsy / Bone Marrow Aspiration Examination. A bone marrow sample is taken from the iliac crest using a thin needle and syringe. Part of the obtained sample is used for examination under a microscope in order to determine the state of the cells. The rest of the sample can be tested for viral infections, a chromosome test, etc.
  • Ultrasound of the spleen.
  • Extremely important for a correct diagnosis is studying the patient’s medical history or family history.

Thrombocytopenia treatment

The best and final treatment for the disease is to identify its cause. Given the large number of diseases that can cause, a list of all possible treatments is unthinkable. Of the drugs, cortisone and immunosuppressants are commonly used. If it is not possible to completely eradicate the pathology that determines low platelets, then they simply keep it under control and control the symptoms.

With heavy bleeding, the introduction of a platelet concentrate is possible.

In cases where a blood test shows a platelet count of less than 10,000 cells per milliliter of blood, immediate transfusion is necessary.

In case of splenomegaly, surgical splenectomy, i.e. organ removal, may be required.

Low platelets during pregnancy

Exist typical thrombocytopenia in pregnancyassociated with pregnancy toxicosis or preeclampsia (high blood pressure, fluid retention and swelling, protein in the urine), which is called HELLP syndrome (H = hemolysis, E = elevated, L = liver enzimes, L = low, P = platelets). In some cases, HELLP syndrome in combination with preeclampsia gives such problems that a pregnant woman needs hospitalization.

In the case of a pregnant woman who suffers from thrombocytopenia, an assessment of the condition by a team of a hematologist, gynecologist, and possibly an immunologist is required. In the event that the mother's platelets are below 50,000 cells per milliliter of blood, a cesarean section is necessary, which prevents any risk of bleeding.

Low platelets and nutrition

It is impossible to make a diet that compensates for the low platelet count, because it is impossible to take into account all the many causes of thrombocytopenia, some of which are in no way connected with nutrition.

However, as with almost all unusual results of blood tests, the patient is interested in what is better to eat and which foods to choose. In this case, you can only give general advice - follow a well-balanced diet, in which preference is given to complex sugars (cereals), legumes, lean meat, fish, vegetable fats, polyunsaturated fatty acids (olive oil). Of course, it is necessary to limit the consumption of alcohol and intoxicating substances such as coffee or tea.

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