Thrombocytopenia is a pathological condition in which the number of platelets in the peripheral blood decreases. As a result, there are problems associated with slowing down bleeding in small vessels. Often the described problem is an independent disease, sometimes it occurs as a symptom.
The disease develops mainly in preschool age or after forty years. The most common type is called idiopathic thrombocytopenia. As a rule, women suffer, if we talk about the statistics of the development of the disease. Among children, thrombocytopenia is diagnosed in 50 cases per million.
Causes of disease
This form of the disease is caused by the destruction of platelets, which occurs most often in the spleen. Sometimes such a process occurs in the liver, lymph nodes and blood vessels. Idiopathic thrombocytopenia is also called autoimmune. As a result, the number of platelets in the peripheral blood decreases due to their increased destruction. Exact reasons beforehave not been installed yet. Doctors say that this disease can be transmitted at the genetic level. There are also known factors that can provoke it. These include hypothermia, vaccinations, infections of a viral and bacterial nature, medicines, insolation in excess.
On platelets, like on any cells in the body, there are antigens. These are molecular complexes. When foreign substances enter the body, the immune system immediately begins to produce antibodies. They act on antigens. This process ends with the fact that the cell on which the latter are located is destroyed.
Consequences
When a person develops idiopathic thrombocytopenia (ICD-10: D69.3), the spleen produces antibodies to the platelets needed by the body. As a result of certain processes, when the bodies enter the spleen, they are immediately destroyed. Therefore, the life of platelets becomes shorter by several hours.
Due to a similar process in the body, the liver begins to produce thrombopoietin in large quantities. Therefore, more platelets and megakaryocytes are produced in the bone marrow. However, due to the destruction of the former in the body, brain exhaustion occurs, a disease such as thrombocytopenia develops.
In pregnant women, this problem can lead to the destruction of the bodies even in the fetus.
Degrees of disease
The treatment of idiopathic thrombocytopenia depends entirely on the degree and severity of the disease. Let's take a look at each one.
Thrombocytopenia can be mild, moderate or severe.
- Lung is accompanied by a problem in which the concentration of platelets in one microliter is from 50 to 150 thousand. This amount allows you to maintain the condition of the vessels, and also prevents the exit of blood from the channel. As a rule, bleeding does not appear at this stage. Treatment is not required. The doctor should conduct tests and observe the patient, trying to identify the cause of the decrease in the number of bodies.
- Average is characterized by the concentration of a substance from 20 to 50 thousand in one microliter. Problems may appear in the form of hemorrhage in the mouth, from the nose, and so on. This can worsen the condition of the gums. With minor bruises and injuries, severe hemorrhages appear. Treatment is prescribed only if there are factors that affect the development of bleeding.
- Severe is manifested by the concentration of platelets in the blood below 20 thousand per microliter. Hemorrhages constantly occur in the skin, as well as other symptoms of hemorrhagic syndrome. At the same time, all patients feel good, complaints are associated exclusively with a cosmetic defect.
Problem Mechanism
Platelets among their functions have one of the most important - it is to stop bleeding in the body. Therefore, if their concentration decreases, then the problem with stopping the blood will be quite acute. Symptoms of idiopathic thrombocytopenia in children and adults begin to appear only if a person has less than 50 thousand platelets in one microliter of blood. However, all manifestationssome patients are minimal and do not bring discomfort, so such a disease is considered dangerous. One of the serious consequences is the development of severe anemia and cerebral hemorrhage.
The disease develops in the same way in all cases. First, the number of platelets in the blood decreases. Because of this, problems with the nutrition of blood vessels begin and, accordingly, they become brittle. After such a process, they are destroyed even under the influence of non-hazardous factors. Given that there are few platelets, there is no platelet plug in the vessels. Therefore, with the development of idiopathic thrombocytopenia (ICD-10: D69.3), a large amount of blood goes into the surrounding tissues.
Symptomatics
Let's look at the symptoms in more detail.
- Unstoppable bleeding after tooth extraction. During the elimination of the tooth, the artery and capillaries in the gum are torn. Normally, bleeding stops in 5-20 minutes. Therefore, if there are problems with the content of platelets in the blood, it will go on for a long time.
- Hemorrhage into the skin and mucous membranes. This symptom is the most specific and is considered the main one. The patient develops small red spots, especially in places where clothing presses. They occur due to the fact that the skin and mucous membranes are saturated with blood. There is no pain, the spots do not disappear if you press on them. There are petechiae and ecchymosis. The former are single hemorrhages, and the latter are large spots. Also canthere are red and blue smudges that turn green and yellow over time.
- Long and heavy periods. As a rule, in women, menstruation lasts from three to five days. In this case, the volume of secretions is not more than 150 ml, including the layer of the rejected surface. Of this amount, blood occupies from 50 to 80 ml. If thrombocytopenia is observed, then menstruation becomes more abundant.
- Persistent nosebleeds. The nasal mucosa has a large number of capillaries. When the concentration of platelets decreases, they become brittle. Provoking factors should be noted sneezing, colds, microtrauma, as well as foreign bodies. The blood will be bright red. Bleeding in idiopathic thrombocytopenia can last several tens of minutes, so the person may even lose consciousness.
- Blood in urine. This symptom has its own name - hematuria. It manifests itself in the case when a person has a hemorrhage in the bladder. Urine can have a different color, depending on the amount of blood. Sometimes its content is so low that it can only be detected through research in the laboratory.
- Gum problems. Some patients may experience bleeding when brushing their teeth. Stopping him is hard enough.
- Bleeding in the gastrointestinal tract. This symptom occurs due to the fragility of blood vessels and when eating heavy, hard food. Blood can be passed out of the body with feces (stained red) or with vomiting. The last symptom suggests that a person has bleeding in the mucosastomach. Sometimes this can cost a person a life.
Additional symptoms may include those that are specific to the disease causing the platelet problem.
Diagnosing the problem
Most often, the problem of reducing platelets in the blood is not independent, but a symptom of some disease. In order to accurately and correctly identify the cause, a correct diagnosis should be made. Then the treatment of idiopathic thrombocytopenia and purpura will be most effective. Consider all diagnostic methods.
A general blood test is mandatory. Thanks to him, you can find out what blood consists of, the number of bodies, as well as the size and shape of all its constituent cells. By determining the bleeding time, you can find out the state of platelets, which are responsible for blood clotting. A puncture of the red bone marrow is taken. It is necessary in order to examine the taken particles under a microscope. As a rule, their number does not exceed 10-20 ml. It must be remembered that thrombocytopenia in idiopathic purpura occurs due to the destruction of bodies, so the examination will be comprehensive.
Thanks to the method of detecting antibodies, it is possible to identify why platelets in the blood are deformed. Be sure to conduct a genetic study. It is necessary in order to understand the cause of the problem. The doctor may also order an MRI and an ultrasound. The first study allows obtaining data on the state of all organs and vessels, and the second methodwill help determine the size of the spleen, liver, and in the presence of tumors will show them. You also need to determine the time of blood clotting. This is the interval at which blood clots will begin to form after a wound appears, allowing the bleeding to stop.
Deciphering indicators
As mentioned above, platelets are destroyed in the spleen. With the help of a bone marrow puncture, this problem can be determined, since it will be maximally depleted when platelets are produced in large quantities.
When making a diagnosis for idiopathic thrombocytopenia, the following indicators are taken into account: the normal size of platelets in a blood smear, the presence of antibodies that destroy bodies. When conducting OAC, results come in which a low platelet count is described. Also, when diagnosing a similar problem, additional research is needed. They will rule out other autoimmune diseases.
Do I need hospitalization?
Those patients who have a mild degree of idiopathic thrombocytopenia (ICD-10: code D69.3) do not need hospital treatment. As a rule, the doctor only observes their condition. It is necessary to periodically consult with a hematologist and do a comprehensive examination. Then you can quickly and correctly identify the cause of the decrease in the number of platelets in the blood.
If the patient does not have hemorrhagic syndrome, but is diagnosed with an averagethe degree of the disease, then the doctor prescribes treatment at home. The specialist must necessarily inform the person about what kind of disease he has, what it threatens and how to deal with bleeding. While the treatment is being carried out, they should limit their physical activities, get more rest and take all the medicines that have been prescribed by the doctor. Sometimes some doctors diagnose code 68.8 as idiopathic thrombocytopenia. However, this is incorrect, as this ICD-10 code is specific to problems in which lupus erythematosus inhibitors are present.
In what case are they hospitalized?
All those patients who have less than 20,000 platelets per microliter in their blood should be hospitalized. Otherwise, their condition may seriously worsen. In the hospital, they should be fully monitored.
If a patient has constant hemorrhages in the face, nose, mouth, regardless of the content of bodies in the blood, then he must be hospitalized. Such a symptom indicates that the disease is advanced and requires immediate treatment.
Medication for thrombocytopenia
Medication is often used in the presence of immune thrombocytopenia. The tasks of the doctor during therapy is to eliminate redness and rashes, to identify the causes of the problem. Also, if the problem is not independent, the primary disease should be treated.
Drug descriptions
Let's look at the medications needed to treat the problem.
- Immunoglobulin intravenously. Thethe drug reduces the formation of antibodies, blocks platelet antigens, which allows antibodies not to attach to them for further destruction, fights viruses. The course of treatment of idiopathic thrombocytopenia, the causes of which are described above, with this remedy is 5 days. Take 400 mg per 1 kg per day.
- "Eltrombopag". This drug reduces the risk of bleeding. It is a synthetic substitute for thrombopoietin. Due to this, the drug improves the production of platelets and megakaryocytes. The drug should be purchased in the form of tablets. No more than 50 mg can be used per day. If there is no desired effect, then the dose can be increased to 75 mg, but you should always consult with your doctor.
Additional funds
- "Etamzilat". The tool reduces the fragility of blood vessels, normalizes blood circulation and enhances the formation of platelets at the site of injury. The drug should be taken after meals three times a day, 500 mg. This medication has a number of contraindications, including pregnancy. With idiopathic thrombocytopenia in pregnant women, it is forbidden to take it.
- "Prednisolone". Thanks to this agent, less antibodies are formed in the spleen, they become less active and do not bind to the antigens of the bodies, the risk of platelet destruction decreases and the strength of all vessels increases. At the beginning of treatment, the dose per day should not exceed 40-60 mg, while they should be divided into three doses. If necessary, increase the dosefor 5 mg. Treatment with this drug is carried out for 1 month. If the patient has a period of remission, then the drug is canceled gradually, this cannot be done abruptly. You need to reduce the dose by 2.5 mg every week.
Results
You have learned what it is - idiopathic thrombocytopenia. By understanding the mechanism of the problem and its causes, risk factors, you can easily avoid the problem. If even small symptoms appear, you should definitely consult a doctor in order to eliminate them in time.
