Definition of thrombocytopenia
In the medical field, he defines himself thrombocytopenia the finding of circulating platelets in numbers less than 150,000 units per mm3 of blood, detected by the blood count performed at least with two different anticoagulants. Therefore, thrombocytopenia outlines a parameter indicative of blood coagulation capacity: in general, the quantity defined as "normal ”(Or physiological) number of platelets in the blood is between 150,000 and 400,000 units per mm3.
Thrombocytopenia - also called thrombocytopenia (from thrombocytes = platelets) - is a rather worrying morbid condition, as it represents the most common cause of bleeding diathesis.
Step back…
Platelets (or thrombocytes), together with red and white blood cells, are very important constituents of the blood: we are not talking about real cells, but rather about tiny fragments of cytoplasm of megakaryocytes circulating inside the bone marrow. Platelets play a role. of primary importance: they are involved, in fact, in the complex function of regulating haemostasis: in other words, platelets are involved in the blood coagulation process.
Symptoms
In general, spontaneous bleeding is rather difficult when the values of platelets in the blood are between 50,000 and 150,000 units per mm3: in such situations, bleeding can occur following surgery or trauma. When, on the other hand, the platelets drop between 20,000 and 30,000 thrombocytes per mm3, the risk of spontaneous hemorrhage is more likely: bleeding is instead ascertained and worrying when thrombocytopenia falls below 10,000 / mm3.
As can be guessed, thrombocytopenia is closely related to platelet hemorrhagic syndrome, which can occur in different forms and entities, both according to the subject and to the values of platelets circulating in the blood: clearly, the more severe the thrombocytopenia, the more severe the symptom picture of the patient.
In the case of severe thrombocytopenia, bleeding can occur with bruising (where there is trauma), epistaxis (nosebleeds), gastrointestinal and / or urinary bleeding and menorrhagia. In extreme cases, thrombocytopenia can cause brain bleeding. .
In any case, it is important to reiterate that the symptoms related to thrombocytopenia are heavily linked to the platelet count: in most cases, the lack of platelets in the blood is diagnosed randomly, without the patient complaining of any symptoms (even at values below 20,000 platelets / mm3).
According to this, a question arises: why do some people complain of symptoms and others don't? The symptoms generated by the lack of thrombocytes are not linked only to the absolute number of these, but also to their functional capacity: in addition, numerous other factors must be taken into account, such as concomitant diseases, presence / absence of coagulation elements, alterations in the blood blood vessels, triggering cause, etc.
Clearly, former leukemia patients are more at risk not only of thrombocytopenia but also of severe symptoms starting from platelet values close to normal: a similar argument is also valid for patients with bone marrow failure. As we will see in the next paragraph, even the excessive intake of NSAIDs - altering the correct platelet function - can be responsible for bleeding, more or less serious.
Causes
The etiological study of thrombocytopenia is quite complex, as the triggering causes are many and varied; in addition to the countless etiological factors, it is good to point out that each organism reacts differently, also and above all on the basis of the patient's history and state of health.
First of all, the platelet disorders linked to a marked reduction in the production of platelet precursors, megakaryocytes, should be mentioned: generally, this is related, in turn, to serious pathologies (carcinomas, leukemias, etc.), in which diseased cells infiltrate the marrow bone.
Sometimes, infectious diseases, rubella, mononucleosis, chicken pox and radiation can also severely affect blood platelet values.
A frequent cause of thrombocytopenia due to excessive consumption of platelets it is represented by disseminated intravascular coagulation: we are talking about a serious pathology in which the abnormal activation of the coagulation cascade generates microthrombi. This form of thrombocytopenia can be aggravated by bacterial infections (eg salmonellosis).
Even the deficiency of vitamins B12 and B9 (folic acid) or rare syndromes (eg May-Hegglin anomaly), together with frequent infections, megaloblastic anemia and eczema can contribute to alter the blood platelet concentration, triggering platelet disorders of various degrees.
Again, blood thrombocyte deficiency can be linked to one destruction of the same: potent drugs, such as antibiotics and chemotherapy, as well as systemic diseases and severe infections can gradually or suddenly destroy platelets.
In other patients, the decrease in platelet values depends on the seizure of thrombocytes, in which the spleen is generally responsible (typical thrombocytopenia due to cirrhosis of the liver).
Other articles on "Thrombocytopenia"
- Thrombocytopenia: causes, diagnosis, therapy
- Thrombocytopenia - Medicines for the treatment of thrombocytopenia
- Thrombocytopenia in brief, Summary of thrombocytopenia
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