Why does thrombocytopenia occur?

Why does thrombocytopenia occur? Is thrombocytopenia fatal?

There are many reasons for thrombocytopenia. There are often patients with thrombocytopenia in the ICU. The common causes of the ICU are severe infection, heparin-induced reduction, and so on.

There are many reasons for thrombocytopenia. There are often patients with thrombocytopenia in the ICU. The common causes of the ICU are severe infection, heparin-induced reduction, and so on.

In the entire disease spectrum, the common causes of thrombocytopenia are as follows:

1. Disorders of platelet production

If there is a problem with the platelets, it will of course lead to thrombocytopenia. Such diseases are mainly aplastic anemia, radiation injury, acute leukemia, megaloblastic anemia, advanced myelofibrosis and so on. These mostly belong to the category of hematological diseases, and these diseases are also relatively serious.

2. Platelet destruction or excessive consumption

That is to say, the production of platelets is no problem, but due to the influence of external factors, it is destroyed or consumed too much, which leads to a decrease. Such diseases include primary thrombocytopenic purpura, systemic lupus erythematosus, malignant lymphoma, upper respiratory tract infection, rubella, neonatal thrombocytopenia, post-transfusion thrombocytopenia, DIC (diffuse intravascular coagulation) and so on.

3. Abnormal distribution of platelets

For example, spleen enlargement (when liver cirrhosis occurs), blood is diluted (for example, transfusion of large amounts of stored blood or plasma).

The above are common causes of thrombocytopenia. When a patient is clinically found to have thrombocytopenia, the cause must be found.

Some of them will relieve themselves. For example, the heparin I mentioned above induces thrombocytopenia. As long as you stop using heparin, the platelets will slowly rise by themselves.

If it is a blood disease, it can only be recovered after treatment, such as idiopathic thrombocytopenic purpura. This disease is mainly an autoimmune disease, and the body destroys platelets by itself. At this time, glucocorticoid treatment is needed, and the effects are relatively good Well, if it doesn’t work, you can also cut off the spleen. The spleen is the place where the platelets are mainly destroyed. After the spleen is cut, the thrombocytopenia will be relieved.

Several of the most impressive diseases that cause thrombocytopenia.

1. Idiopathic Thrombocytopenic Purpura

This disease contains three meanings, idiopathic, which refers to the unknown cause, which is currently known to be related to autoimmunity; thrombocytopenia, which points out the main contradiction of this disease, which is the reduction of platelets. Purpura represents the clinical manifestations of the disease, that is to say, this part of patients will have purpura, which is a rash, which is a manifestation of subcutaneous hemorrhage.

This disease usually has a rapid onset, and patients have a tendency to hemorrhage because the platelets are reduced. Platelets are like cement in the building materials. Without it, there is no way to build walls. The human body does not have platelets, and there is no way to stop bleeding. The integrity of blood vessels must rely on the normal number of platelets.
Patients will have bleeding from the skin and mucous membranes, such as petechiae, or bleeding after trauma, nose bleeding and gum bleeding are common. Some women may have menorrhagia, and may be the only clinical manifestation, which is easy to be misdiagnosed.

The treatment is mainly using glucocorticoids. Because it is an autoimmune disease, the curative effect of hormones will be very good, and the short-term effective rate is about 80%. Hormones can inhibit the body’s immunity and reduce platelet destruction. If the effect of regular hormone therapy is not good, splenectomy can be done, and the spleen can be cut off directly. Because the spleen is the main place to destroy platelets. But patients who are too young are contraindications. There can also be some medications, such as the use of anti-CD20 monoclonal antibodies.

2. Leukemia

In patients with leukemia, their own hematopoietic function is impaired, and there is no way to produce red blood cells, white blood cells, platelets, etc., so there will be thrombocytopenia. I have a patient with thrombocytopenia and bleeding to see the doctor. Upon examination of the bone marrow, he was considered to be leukemia.

3. Severe infection

There will be many severely infected patients in the ICU, such as severe pneumonia, abdominal infection, etc. You will find that these severely infected patients will have thrombocytopenia, which is considered to be related to the inhibition of hematopoietic function. If thrombocytopenia, it also indicates a critical condition.
In addition, there are many other diseases that can cause thrombocytopenia. Thrombocytopenia is only a manifestation, and the reason behind it must be found in order to be better treated.

(source:internet, reference only)

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