Thrombocytosis treatment. Causes and treatment of thrombocytosis. Preventive measures for thrombocytosis

Platelets are specific blood cells responsible for one of its most important functions - clotting. Normally, in the blood test in adults, their number is in the range of 250-400 thousand per cubic meter / mm. Their increase over 500 thousand is called thrombocytosis.

Types of thrombocytosis

  1. Clonal is the most dangerous species, a kind of primary.
  2. Essential thrombocytosis (primary) - occurs more often in elderly people after 60 years.
  3. Reactive thrombocytosis (secondary) - children and young people of active age are more likely to be affected. It develops with other blood diseases or any chronic diseases.

Reasons for development

Clonal thrombocytosis is observed in persons over 50-60 years old. The reason is a tumor mutation of hematopoietic stem cells. In this case, there is an increase in the production of platelets with defects and this process is not controlled. In turn, defective cells do not cope with their main function - thrombus formation.

Primary thrombocytosis develops in oncological or benign tumor processes in the hematopoietic system, when an increased proliferation of several islets of hematopoiesis occurs in the bone marrow.

Secondary thrombocytosis is most often observed when:

Let's consider primary and reactive thrombocytosis separately. So.

The symptomatology of primary thrombocytosis is characterized by nonspecific clinical manifestations and accidental detection. This condition is characterized by:

  1. Marked increase in platelets.
  2. Changes in the normal morphological structure and functions, which can cause thrombus formation and spontaneous bleeding in older and elderly people. Most often they occur in the gastrointestinal tract and recur periodically.
  3. With recurrent blood loss, iron deficiency anemia may develop.
  4. The appearance of subcutaneous hematomas, ecchymosis is possible.
  5. Blueness of the skin and visible mucous membranes.
  6. Itching and tingling in the fingers and toes.
  7. Thrombosis with damage to small vessels, which lead to the formation of ulcers or the development of complications such as gangrene.
  8. An increase in the size of the liver - hepatomegaly and spleen - splenomegaly.
  9. Heart attacks of vital organs - heart, lungs, spleen, strokes.
  10. Often there may be symptoms of vegetative-vascular dystonia: migraine-like headaches, high blood pressure, heart palpitations, shortness of breath, thrombosis of vessels of various sizes.
  11. Laboratory diagnostics gives a picture of a high degree of thrombocytosis up to 3000, together with pronounced morphological and functional disorders in them. This manifests itself in an amazing combination of bleeding and a tendency to thrombosis.

Such an unexpressed clinical manifestation of essential thrombocytosis often becomes chronic. At the same time, essential thrombocythemia must be dealt with immediately from the moment of its detection, since with a correctly diagnosed, adequate and accurately selected treatment, it lends itself to therapeutic effects.

Symptoms of secondary or reactive thrombocytosis.

This disease is also characterized by an increase in the level of platelets, but already due to the excessive activity of the hormone thrombopoietin. Its functions include control over division, maturation and entry of mature platelets into the bloodstream. This produces a large number of platelets with normal structure and function.

The above symptoms are joined by:

  • Sharp and burning pains in the limbs.
  • Violation of the course of pregnancy, spontaneous termination.
  • Hemorrhagic syndrome, which is closely associated with disseminated intravascular hemolysis, is disseminated intravascular hemolysis. At the same time, in the process of constant thrombus formation, an increased consumption of coagulation factors occurs.

Thrombocytosis in a child

Reasons:

Primary thrombocytosis in children is a hereditary factor or acquired - leukemia or leukemia.

Secondary thrombocytosis is a condition not associated with problems of the hematopoietic system. These include:

  1. pneumonia,
  2. osteomyelitis,
  3. iron deficiency anemia,
  4. bacterial or viral infections,
  5. diseases or fractures of tubular bones,
  6. splenectomy.

Thrombocytosis Treatment

We have covered the causes of thrombocytosis in sufficient detail, now about the treatment. This disease is multivariate. There is no clear clinical picture. Symptoms are suitable for arterial hypertension, atherosclerosis, anemia, and finally, oncological conditions. Therefore, the successful treatment of thrombocytosis depends on the timely accurate diagnosis, the adequacy of the doctor's prescriptions and strict adherence to the treatment plan on the part of the patient.

I would especially like to note that primary thrombocytosis is a myeloproliferative tumor disease with a favorable prognosis if patients are properly managed. And they can live as long as other people.

Reactive thrombocytosis involves, first of all, the treatment of the underlying disease.

The treatment itself is carried out in 4 main areas:

  • Prevention of thrombocytosis.
  • Cytoreductive therapy.
  • Targeted therapy.
  • Prevention and treatment of complications of thrombocytosis.

Prevention consists in:

  • Leading a healthy lifestyle is quitting smoking, taking drugs, alcohol abuse. Fighting a sedentary lifestyle: playing sports, cycling, fitness.
  • Adjust the power supply. Frequent and fractional food intake. The diet for thrombocytosis should be rich in content:
  • Iodine, which is found in large quantities in kelp - seaweed, fish.
  • Calcium is fermented milk products.
  • Iron - red meat.
  • B vitamins - green vegetables: radish, bell peppers, zucchini, broccoli, etc.
  • Vitamin C is fresh lemon, orange, blackberry juices diluted with water in a 1: 1 ratio
  • Drinking enough water per day up to 2 liters in order to prevent blood thickening, especially in the hot season.
  • Taking lipid-lowering drugs to maintain normal levels of fats (lipids) in the body. In particular, to reduce the number and size of atherosclerotic plaques.
  • Taking antihypertensive drugs in order to maintain a normal level of A / D - blood pressure.
  • Compensation for diabetes mellitus. Continuous observation by an endocrinologist and taking antidiabetic drugs.
  • Hirudotherapy - taking courses of treatment with leeches. The course consists of 5-7 procedures with an interval of 2-3 days. When leeches bite the human skin into the wound, they inject hirudin, which has a unique property - to thin the blood, reducing the level of platelets in it.

Cytoreductive therapy consists of reducing excess platelet formation with the help of cytostatics.

Targeted therapy is aimed at the finest molecular mechanisms of growth of neoplasms, because they are the basis for the development of clonal and essential thrombocytosis.

Prevention and treatment of complications. This disease can also give formidable complications. These include heart attacks of various organs and gangrene of the extremities. In this regard, special attention is paid to drug therapy for all concomitant diseases.

Thrombocytosis can and should be treated. It lends itself well to correction if detected early. Contact your doctor immediately at the first manifestation of any of the above symptoms. And be always healthy!

Blood clotting is an extremely important thing that ensures the body's recovery from injuries. This function is provided by special blood cells - platelets. When there are too few platelets in the blood, this is certainly very bad, because then there is a risk of bleeding even from a relatively small wound. However, the opposite case, when the level of platelets is too high, does not bode well, because this can lead to the formation of blood clots. An increased number of platelets in the blood is called thrombocytosis.

Because of what the level of platelets can increase

If we talk about a disease such as thrombocytosis, the causes of its occurrence directly depend on the type of disease. Two types of this disease should be distinguished: primary and reactive. In the first case, the work of stem cells in the bone marrow is disrupted. As a rule, primary thrombocytosis in children and adolescents is not diagnosed: this form is more common in older people - 60 and above.

Reactive (secondary) thrombocytosis develops against the background of any disease. The most common among them:

  • Infectious diseases, both acute and chronic.
  • Severe blood loss.
  • Iron deficiency in the body (iron deficiency anemia). This reason is especially characteristic if there are too many platelets in the child's blood.
  • Cirrhosis of the liver.
  • Malignant tumors (this is especially true for neoplasms in the lungs or pancreas).
  • Osteomyelitis.
  • Inflammatory processes in the body.

In addition to the above reasons, the secondary form of the disease can occur as a response to the intake of drugs such as adrenaline or vincristine, a sharp refusal to take alcohol and heavy operations.

Symptoms of the disease

Usually, any symptoms occur only with primary thrombocytosis. If an increased number of platelets in the blood is caused by some kind of ailment, then the symptoms of thrombocytosis in both an adult and a child are easy to miss for signs of a primary disease. However, if a patient is undergoing treatment in a hospital, then blood tests are done regularly, and it is simply impossible to miss such an alarming sign as a rapid increase in the number of platelets in the blood.

Those who have no history of any diseases that can provoke essential thrombocytosis should visit a specialist if the following symptoms are found:

  • Bleeding of various nature: nasal, uterine, renal, intestinal, etc. With intestinal bleeding in a child, streaks of blood may be found in the stool.
  • Severe pain in the fingertips. These symptoms are most common with an increased platelet count.
  • Constant itching. Of course, this symptom is typical for many other diseases, in particular, skin diseases. Therefore, just in case, the child needs to be taken to a dermatologist.
  • Subcutaneous hemorrhage. If a child has bruises for no reason, then this is a rather alarming sign.
  • Puffiness, cyanosis of the skin.
  • Weakness, lethargy.
  • Vision disorders.

Of course, symptoms do not have to appear all at once - sometimes 2-3 signs from the list above indicate an elevated platelet count. They should not be ignored, because the health and life of a person can depend on it: both an adult and a child.

Diagnosis of thrombocytosis

The first thing that begins with the diagnosis of any disease, including such a disease as thrombocytosis, is the collection of anamnesis. The doctor needs to know what diseases the patient suffered earlier (this is especially important for identifying the causes of secondary thrombocytosis), as well as signs indicating the presence of an increased level of platelets that a person (adult or child) has at the time of treatment. But, of course, additional research and analysis is also necessary. These include:

  • General blood analysis. A simple but very effective way to identify an increased number of platelets in the blood, as well as their possible pathologies.
  • Bone marrow biopsy.
  • Ultrasound of the abdominal cavity and pelvic organs.
  • Molecular research.

In addition to such studies indicating an increased level in general, a number of tests are also necessary to make sure that thrombocytosis in an adult or child is not caused by any disease or pathology.

How to cure a disease

The main vector that determines how thrombocytosis will be treated is the type of disease and the severity. If thrombocytosis is reactive, then treatment must first be directed to the root cause, that is, the disease that led to an increase in the number of platelets in the blood. If thrombocytosis manifests itself as an independent disease, then treatment here depends on how much the platelet level deviated from the norm. If such changes are insignificant, then a change in the way of eating, as well as the use of traditional medicine, will help to solve the problem. General treatment is most effective with the following products:

  • Saturated Fat. These include fish oil (it is sold in capsules, so you won't have to "remember the taste of childhood"), flaxseed and olive oil.
  • Tomatoes, tomato juice.
  • Sour berries, citrus fruits.
  • Onion garlic.

Bananas, nuts, black chokeberry, pomegranates, rose hips and lentils are prohibited foods that increase blood viscosity. You should also avoid the use of alcohol, diuretics and various hormonal drugs (including contraceptives).

If it is not possible to do with one correction of the diet, then the treatment involves the use of special medications to thin the blood. It is better to check their exact names in consultation with a doctor.

At first glance, thrombocytosis is not too dangerous, but it is this syndrome that entails the formation of blood clots, which, in unfortunate circumstances, can even lead to death. Therefore, in case of any problems, it is important to immediately go to a specialist and, if necessary, immediately begin treatment.

Thrombocytosis is an increase in the number of platelets above normal. From the point of view of pathogenesis, thrombocytosis is divided into two groups: primary and reactive.

Primary thrombocytosis

Primary thrombocytosis results from a defect in hematopoietic stem cells, which leads, at least in part, to autonomic hematopoiesis and impaired stem cell development. Thus, primary thrombocytosis occurs almost exclusively as a complication of one of the myeloproliferative disorders (chronic myeloid leukemia, polycythemia, essential thrombocythemia, idiopathic myelofibrosis) - clonal diseases of hematopoietic stem cells, which are characterized by excessive proliferation. In rare cases, primary thrombocytosis occurs in connection with one of the myelodysplastic syndromes, especially 5q-syndrome, and also in connection with idiopathic annular sideroblastic anemia.

The number of platelets in patients with primary thrombocytosis can vary: from values ​​not much higher than normal to several million in 1 μl. The morphology of platelets also changes. Giant platelets and even fragments of the cytoplasm of a megakaryocyte found in peripheral blood smears indicate a primary process, although these changes may be absent. Since primary thrombocytosis is the result of a defect in pluripotent hematopoietic stem cells, there is usually a change in hematocrit and / or white blood cell count. The presence of splenomegaly also confirms the primary process. The bleeding time in patients with primary thrombocytosis varies: it can be decreased, normal, prolonged. However, most patients show abnormalities in platelet function, most often adrenaline-induced aggregation.

Clinical manifestations of the disease are largely associated with the underlying pathological process. In this case, the occurrence of thrombosis and bleeding is explained by the presence of primary thrombocytosis. A typical complication is thrombosis of vessels of unusual localization (for example, mesenteric veins, hepatic veins, arteries of the fingers). Digital arterial ischemia leads to a clinically pronounced syndrome of erythromelalgia, painful erythema, and edema of the fingers. The elderly sometimes have attacks of ischemia, including heart attacks. Hemorrhagic complications develop 2 times more often than thrombotic ones and are localized, as a rule, in the gastrointestinal tract. There is no clear link between an increase in platelet count and the risk of thrombotic or hemorrhagic disorders. But if thrombosis and hemorrhages occur with a primary platelet disorder, it is believed that the likelihood of complications can be significantly reduced by reducing the platelet count.

Reactive thrombocytosis

Reactive thrombocytosis manifests itself as a consequence of a pathological process that is not believed to affect hematopoietic stem cells, i.e., the regulatory mechanisms that control thrombocytopoiesis and stem cell development are not impaired.

Reactive thrombocytosis should be considered a benign disorder. Although the number of platelets is increased, their morphology and function are not changed. Normal platelet aggregation can help differentiate between reactive and primary forms of thrombocytosis. In the reactive variant, the number of circulating platelets rarely exceeds 1,000,000 / μl; significantly higher values ​​indicate a primary disorder. No clear relationship was found between the presence of reactive thrombocytosis and the development of thrombotic or hemorrhagic clinical manifestations; and, therefore, there is no indication for treatment with inhibitors of platelet function and therapy aimed at reducing their number.

The possible causes of reactive thrombocytosis are manifold:

  • splenectomy,
  • major surgical operations (sometimes),
  • Iron-deficiency anemia,
  • acute bleeding
  • chronic inflammation (especially rheumatoid arthritis, colitis),
  • acute and chronic infections (especially chronic lung infections),
  • osteomyelitis,
  • amyloidosis,
  • cirrhosis of the liver,
  • malignant diseases (especially lungs, pancreas, Hodgkin's disease),
  • refusal from alcohol,
  • hemolytic anemia,
  • taking medications (vincristine, adrenaline),
  • recovery from thrombocytopenia (treatment of B12 and folate deficiency).

"Asplenic" thrombocytosis is maximal between the 2nd and 3rd weeks after splenectomy and lasts for a relatively short time (from several weeks to several months). Its occurrence is associated with the removal of an organ, where sequestration and destruction of platelets occurs, as well as, apparently, the synthesis of antiplatelet antibodies and the production of a humoral factor that has an inhibitory effect on the bone marrow.

In many cases, reactive thrombocytosis is associated with systemic inflammatory diseases and is believed to result from the release of immunomodulatory cytokines that secondarily stimulate platelet production. This model is most consistent with the state of rheumatoid arthritis, when the content of interleukin-6 (IL-6) in the blood serum directly correlates with the degree of thrombocytosis. Interleukin-6 is known as an anti-inflammatory cytokine that also stimulates megakaryocyte polyploidization and platelet formation.

The cause of thrombocytosis in patients with oncological pathology is probably the irritating effect of biologically active substances produced by the tumor on the megakaryocytic lineage of the bone marrow. This effect may be direct in patients with tumor metastases in the bone. Most often, thrombocytosis is observed in hypernephroid kidney cancer, sarcomatous lesions of the lungs, lymphogranulomatosis. In the clinical analysis of blood in such patients, an increase in ESR may be present. In the coagulogram, hyperfibrinogenemia and a tendency to hypercoagulability are often noted.

There are thrombocytosis accompanying fractures of large bones of the skeleton (especially often - of the femur). In addition, prolonged hypoxemia, in addition to erythrocytosis, can also cause thrombocytosis.

An increase in platelet count is sometimes a component of the body's natural response to prolonged chronic bleeding. This can be observed (albeit quite rarely) in patients with cirrhosis of the liver with bleeding from varicose veins of the esophagus, in patients with ulcerative lesions of the gastrointestinal tract. In such patients, thrombocytosis is often combined with signs of iron-deficiency anemia.

Patients with B12-deficiency anemia may experience a transient increase in platelet counts during the recovery of red blood counts following therapy.

Reactive thrombocytosis cannot cause thrombohemorrhagic complications and do not require special correction. The efforts of the attending physician should be aimed at the timely recognition and immediate treatment of the disease that caused the thrombocytosis.

Literature:

  • Schiffman F.J. Blood pathophysiology. Translation from English - Moscow - St. Petersburg: "BINOM Publishing House" - "Nevsky Dialect", 2000
  • Kozlovskaya L.V., Nikolaev A. Yu. Textbook on clinical laboratory research methods - Moscow, Medicine, 1985
  • K. M. Abdulkadyrov, O. A. Rukavitsyn, E. R. Shilova, V. Yu. Udalyeva, - Hematological syndromes in general clinical practice, reference book, - St. Petersburg, - Special literature, ELBI, - 1999
  • Willoughby M. Pediatric Hematology, - Moscow, "Medicine", 1981

Myeloproliferative neoplasm, characterized by a significant increase in the number of platelets in the blood and increased proliferation of megakaryocytes in the bone marrow. The etiology is unknown.

CLINICAL PICTURE AND NATURAL CURRENT

1. Symptoms:

in many cases, ET is diagnosed incidentally by CBC examination for other indications. Symptoms are associated with blood clots in the microcirculation: paresthesias of the distal parts of the limbs, scotoma, erythromelalgia, headaches and dizziness. Large vessel thrombosis (the most common complication): arterial (acute coronary syndromes, stroke, Budd-Chiari syndrome, portal vein thrombosis). Bleeding from the mucous membranes and gastrointestinal tract (in ≈15% of patients) caused by dysfunction of blood platelets occurs especially in patients with a blood platelet count> 1–1.5 million / μL, who may develop acquired von Willebrand syndrome. Have<10–15 % пациентов встречаются как тромботические, так и геморрагические осложнения. Умеренное увеличение селезенки у 10–15 % больных.

2. Natural flow: can be asymptomatic for many years. Later complications arise: thrombosis (annual risk 1-3%), bleeding, transformation into myelofibrosis (15-year risk 5-10%), transformation into AML or MDS (3%).

Additional research methods

1. General analysis of peripheral blood: increased platelet count, irregular shape and size; the number of leukocytes and the concentration of Hb are within the normal range or increased.

2. Bone marrow aspiration biopsy and trepanobiopsy→ Diagnostic criteria.

3. Molecular research: in 90% of patients, 1 of 3 driver mutations: V617F mutation of the JAK2 gene (in ≈60%), mutations in the CALR gene (20–25%), mutations in the MPL gene (in 3–4%). In 10-15% of patients, the above-mentioned molecular changes ("triple negative") are absent.

4.  Other examinations: for differential diagnosis with reactive thrombocytosis in case of negative results of molecular tests (eg, ferritin concentration, ESR, CRP), platelet dysfunction (most often impaired aggregation under the influence of adrenaline, ADP and collagen).

Diagnostic criteria (WHO 2016) All large criteria or the first 3 large criteria and a small criterion must be present.

Big criteria:

1) constant platelet count ≥450,000 / μl;

2) in bone marrow biopsy, proliferation of a megakaryocytic line with an increased number of large mature megakaryocytes with a multilayered nucleus; the absence of a significant increase or shift to the left of neutrophilic granulocytopoiesis and erythropoiesis; very rarely, minor reticulin fibrosis (grade 1);

3) non-compliance with the WHO criteria for CML, PI, PMF, MDS and other neoplasms of the hematopoietic system;

4) exclusion of polycythemia vera (PI), primary myelofibrosis (PMF), CML, MDS and other neoplastic diseases of the leukocyte system;

5) the presence of 1 of the above-mentioned driver mutations.

Small criterion: presence of a clonal marker or lack of evidence of reactive thrombocythemia → Differential diagnosis.

Differential diagnosis

1. Thrombocytosis accompanying other hematopoietic tumors: PI, CML, PMF, MDS 5q–, MDS / MPN-RS-T.

2. Reactive thrombocythemia: in solid tumors (mainly of the lungs and pancreas), iron deficiency anemia, chronic inflammatory and infectious diseases, after acute blood loss, after removal of the spleen, in chronic alcoholism, in ordinary blood donors, in hemolytic anemia, in narcotic anemia ...

3. Familial thrombocytosis.

4. Pseudothrombocytosis: cryoglobulinemia, fragmentation of red blood cells or tumor cells in the blood.

Choice of treatment method

 depends on the presence of risk factors for thrombotic complications (age> 60 years and a history of thrombotic complications). In the low-risk group (no risk factors), use ASA without cytoreductive therapy, and in the high-risk group (≥1 risk factor above) also use cytoreductive therapy. You may also consider it in patients with platelet counts> 1.5 million / μL (due to an increased risk of bleeding), with progression of myeloproliferation (eg enlarged spleen), uncontrolled general symptoms, and microcirculatory disorders resistant to ASA treatment.

1. Cytoreductive drugs: The first line drug is hydroxyurea (GM), the initial dose is 15 mg / kg / day, then the dose should be modified to stabilize the platelet count ≈450,000 / μl, as well as to avoid anemia or neutropenia. It is possible to leave the platelet count slightly above normal in patients receiving cytoreductive therapy, provided that leukocytosis is controlled, which is the main risk factor for thrombosis.

Second-line treatment in patients who have not achieved a significant reduction in platelet count or with hydroxyurea intolerance:

1) anagrelide, initially 1.5–2 mg / day, maintenance dose depending on the number of platelets;

2) IFN-α (or Peg-IFN-α2a), the initial dose is 3-5 million U / day n / a 3 × / week. (Drugs of choice in pregnant women, or planning pregnancy);

3) in patients with expected short survival, consider using busulfan.

Complete remission:

1) the disappearance of objective symptoms and a significant improvement in subjective symptoms, lasting ≥12 weeks;

2) remission of CBC values ​​lasting ≥12 weeks (platelet count ≤400,000 / μl, leukocyte count ≤10,000 / μl, leukoerythroblastosis);

3) absence of disease progression, thrombosis and bleeding;

4) histological remission of the bone marrow.

Partial remission: This is the fulfillment of the first three criteria, without remission of the bone marrow.

2. Antiplatelet drugs: used in patients with microcirculation disorders, JAK 2 mutation, or cardiovascular risk factors; contraindicated in patients with acquired von Willebrand syndrome.

An increased number of platelets in the blood is called thrombocytosis.

The causes of this pathology can be a wide variety of factors. Determination of the type and treatment of thrombocytosis depends on the reason for the increase in the level of platelets in the blood.

A platelet is a blood cell responsible for blood clotting. The normal number of platelets in the blood in adults on average ranges from two hundred to four hundred thousand units per one cubic milliliter of blood. If this indicator rises (five hundred thousand or more), then we are talking about pathology.

Clonal and primary thrombocytosis are considered one of the most dangerous types, as they are caused by disorders associated with bone marrow stem cells. It is the stem cells that are responsible for the production of platelets and their entry into the blood.

In the case of clonal thrombocytosis, the cause of the pathology is defective (more often tumor) processes in stem cells, and they begin to uncontrollably produce large numbers of platelets.

At the same time, the cells produced are unhealthy and cannot function properly. As a result, their interaction with other blood cells is disrupted, and for this reason, thrombus formation processes do not proceed correctly.

Primary thrombocytosis (or essential thrombocythemia) causes stem cells to malfunction, which is associated with their proliferation, which creates additional sources of platelet production.

As with clonal thrombocytosis, essential thrombocythemia reveals defective produced cells with an inability to function properly. Moreover, the platelets themselves are abnormally large.

With these types of pathology, a blood test often reveals platelet aggregation, that is, their adhesion, which means the risk of blood clots.

The likelihood of developing clonal or primary thrombocytosis is high in people over fifty; young people and children are usually not affected by this deviation.

Symptoms of thrombocytosis caused by impaired functioning of stem cells are quite pronounced.

The main signs of thrombosis disorder include:

  • frequent bleeding (nose, uterine, gastrointestinal, etc.) and anemia caused by them;
  • blue or black spots on the skin;
  • subcutaneous hemorrhage;
  • vegetative-vascular dystonia and its signs (cold extremities, headaches, tachycardia, unstable pressure, etc.);
  • venous or arterial thrombosis;
  • enlargement of the spleen (splenomegaly);
  • in rare cases, gangrene.

Treatment of these types of thrombocytosis proceeds according to the recommendations of a hematologist. As a rule, he prescribes antiplatelet agents (acetylsalicylic acid, Ticlopidine, etc.).

It is not recommended to take these drugs on your own, since only a doctor can calculate the dosage and course of treatment appropriate for the age and complexion of the patient.

Secondary thrombocytosis

The increased content of platelets in the blood can be caused by reasons not associated with violations of the processes of hematopoiesis. This pathology is called secondary thrombocytosis.

When diagnosed with secondary thrombocytosis, the causes can be very diverse.

These include:

  • surgical intervention;
  • serious injuries (injuries, fractures);
  • chemotherapy performed;
  • iron deficiency in the body;
  • inflammation of various organs and tissues;
  • cancer;
  • removal of the spleen (this organ is the site of the decay of obsolete platelets, therefore, its removal provokes an uncontrolled growth of platelets with a general decrease in blood volume);
  • infections (especially meningococcal);
  • viruses;
  • fungus;
  • taking certain medications;
  • pregnancy.

All cases, except pregnancy, are subject to medical supervision. After eliminating the cause of thrombocytosis, a blood test should not contain more than 450 thousand platelets.

Thrombocytosis during pregnancy is not considered a significant deviation, since it is explained by a cardinal restructuring of the whole body, a change in hormonal levels.

As a rule, the correction of the number of platelets in the blood of a pregnant woman is carried out only in cases of too many of them (about one million per milliliter).

In other cases, thrombocytosis is simply monitored by a hematologist throughout pregnancy.

Symptoms of secondary thrombocytosis are similar to those of primary thrombocytosis, that is, the patient experiences nasal, uterine, gastric, renal bleeding, traces of subcutaneous hemorrhage appear, and vascular thrombosis is possible.

It is necessary to treat secondary thrombocytosis according to the principle of eliminating the disease that caused the increased platelet count in the blood.

For infectious, fungal, viral diseases, the doctor prescribes treatment with antibiotics and antibacterial, antifungal drugs. Inflammatory processes require similar treatment.

Reactive thrombocytosis

An increase in the level of healthy, non-defective platelets is possible. In this case, the reason is the nonspecific activation of the hormone responsible for the appearance and entry of platelets into the blood. This hormone is called thrombopoietin.

With an increase in the activity of thrombopoietin, a large number of platelets are released into the circulatory system. At the same time, platelets are of normal size and function correctly.

The causes of this pathology can be traumatic disorders in the body, such as:

  • surgical intervention;
  • wounds with profuse blood loss;
  • extreme physical activity (overload).

The second group of causes of reactive thrombocytosis is a variety of infectious and viral diseases, inflammation and chronic diseases.

Most often these include:

  • pulmonary diseases (tuberculosis, pneumonia);
  • anemia (anemia);
  • rheumatism;
  • cancers;
  • inflammation in the gastrointestinal tract.

It is important to distinguish reactive thrombocytosis from primary or clonal thrombocytosis. In the case of the first, there are no pronounced bleeding (they are only with rare exceptions), there is no splenomegaly and vascular thrombosis.

When analyzing blood, to distinguish between these pathologies, a biochemical blood test, ultrasound, and anamnesis of chronic diseases are collected.

In addition, a hematologist may order a bone marrow biopsy to rule out the possibility of primary or clonal thrombocytosis.

By itself, reactive thrombocytosis is not as dangerous as other types of thrombocytosis. For example, with this deviation, the risk of thromboembolism (clogging of the vessel by a detached thrombus) is excluded, in addition, the patient's general well-being does not deteriorate as much as with primary thrombocytosis.

Despite the sluggish manifestation of the symptoms of this pathology, doctors quite successfully diagnose it with the help of various studies.

With mild reactive thrombocytosis (no more than 600 thousand), doctors carry out such treatment that eliminates the cause of the increased platelet count, without touching the hematopoietic process itself. That is, the treatment of infections or inflammation is prescribed.

With proper therapy, reactive thrombocytosis can be eliminated within two to three weeks without risk to the patient.

Thrombocytosis in a child

Thrombocytosis is also possible in children. Moreover, the normative number of platelets in the blood depends on the child's age.

In children under one year old, a healthy indicator is considered to be 100 - 350 thousand, in older children, the norm is equated to the norm of an adult.

In adolescent girls during the first menstrual cycle, a low platelet count is possible (the minimum healthy index is 80 thousand).

In children with thrombocytosis, symptoms may not appear immediately, however, with frequent nosebleeds, with increased fatigue, dizziness, the baby should be shown to the doctor.

Taking blood tests in any case will not be superfluous, since the cause of the malaise can be identified, which is most likely associated with violations of the composition of the blood or the functioning of blood cells.

Since a small child cannot talk about his unhealthy condition, it is recommended to donate blood for a general analysis at least once every six months.

Thrombocytosis in children can be caused by a variety of reasons and is associated with the same disorders and diseases as in adults.

Primary thrombocytosis in young children is most often the result of hereditary or acquired hematological diseases (leukemia, erythremia, etc.).

Secondary thrombocytosis develops against the background of infectious diseases (meningitis, pneumonia, hepatitis) or after trauma and surgery. Often the reason for the increase in the level of platelets in the blood is surgery to remove the spleen.

Treatment of a child with a secondary type of pathology depends on what disease it was caused by.

Usually, doctors prescribe a special diet, antibacterial drugs and folk remedies to eliminate the focus of infection.

With large blood loss or after removal of the spleen, doctors prescribe special drugs to thin the blood for children.

Treatment of primary thrombocytosis is a rather complicated and long process that requires constant medical supervision of a small patient.

In no case should you make decisions on your own about the treatment of a baby, and even more so choose medicines for him.

Usually, parental involvement in the treatment of a child should consist of following dietary recommendations and protecting the baby from stress and illness.

Treatment and diet

Of course, when thrombocytosis is detected, the patient's treatment depends entirely on the doctor's recommendations. Solving this problem on your own is strongly discouraged.

First, the hematologist monitors the patient throughout the illness in order to control the situation.

In many cases, a daily blood test is required, in addition, the doctor may prescribe various tests (ultrasound or biopsy) during therapy.

Secondly, primary or clonal thrombocythemia may require the prevention or timely elimination of its consequences (ischemia or heart attacks of internal organs). For this, doctors prescribe special drugs - anticoagulants.

Thirdly, in the absence of positive results of treatment, the hematologist may prescribe special procedures, such as thrombocytophoresis (artificial removal of excess platelets from the blood) or cytostatic therapy.

As an auxiliary component of treatment, the doctor may recommend hirudotherapy (leech therapy).

Hirudotherapy is possible only when the risk of internal bleeding is completely absent.

Along with drug treatment, a special diet must be followed. From the patient's menu, products that contribute to blood thickening should be excluded: fatty meat, bananas, rose hips, chokeberry, bird cherry berries, nuts (especially walnuts), lentils, buckwheat and semolina.

It is advisable to give up junk food - smoked foods, fried foods, semi-finished products, carbonated drinks.

A diet for thrombocytosis involves an abundance of foods containing iodine, calcium, magnesium and B vitamins and vitamin C.

These products include:

  • seaweed;
  • cashews and almonds;
  • fish and fish oil;
  • vegetable oils (especially linseed and olive);
  • fresh and sauerkraut;
  • all types of citrus fruits;
  • onion and garlic;
  • chicken and beef liver, heart, lung;
  • some berries: lingonberry, currant, viburnum (summer is a great time to prepare them for future use);
  • ginger;
  • tomatoes and tomato juice;
  • dairy and fermented milk products and drinks.

Any diagnosis related to abnormalities in blood cell counts is subject to complex treatment with medications and diet. Otherwise, the treatment may not bring the desired result.

Are you here:

8093 0

Loading ...Loading ...