Symptoms of thrombocytopenia, early treatment

Thrombocytopenia needs timely treatment. If it becomes serious, it will cause many complications, such as anemia, bleeding gums, nosebleeds, gastrointestinal bleeding, and purpura, which is the appearance of bruises or blood spots on the skin.

1. There is an incubation period before the onset of bleeding symptoms in drug-induced immune thrombocytopenia . The shortest period is within a few hours after taking the medicine, and the longest period is several months later. Usually 5-10 days. It is often accompanied by chills, fever, headache, nausea, vomiting, etc.

2. Other symptoms of immune thrombocytopenia include purpura on the skin , epistaxis or menorrhagia in women, fatigue, pale complexion and dark urine. Occasionally, signs of kidney damage such as hypertension, hematuria, and azotemia may be seen. Neurological symptoms are rare.

3. Coagulation diseases

1. Aplastic anemia and bone marrow diseases: Aplastic anemia caused by various reasons is characterized by a decrease in bone marrow megakaryocytes and reduced platelet production. Thrombocytopenia may be the earliest manifestation of aplastic anemia, or hemoglobin and granulocytes may return to normal after treatment, but platelets have not yet recovered. Thrombocytopenia occurs in bone marrow diseases such as cancer infiltration, mostly because tumor cells damage the megakaryocytes, thus reducing platelet production. In the above two cases, a clear diagnosis can be made by examining the bone marrow. In the former, bone marrow proliferation is low and megakaryocytes are reduced; in the latter, tumor cells may be detected.

2. Physical and chemical factors inhibit bone marrow: Physical and chemical factors such as ionizing radiation, alkylating agents, anti-metabolites, cytotoxic agents, etc., when treating malignant tumors, thrombocytopenia is a common complication, which either directly poisons bone marrow cells or causes immune reactions. Most of these factors cause diffuse damage to the bone marrow, and the patient will show a decrease in pancytopenia. However, the megakaryocytes of a few patients are more sensitive to the effects of radiation, and some patients may only show thrombocytopenia and megakaryocyte decrease.

3. Factors that selectively inhibit megakaryocytes: Chlorothiazides and their synergists can cause thrombocytopenia, not only through the mechanism of producing platelet antibodies, but also by inhibiting the production of platelets. And the latter is more important. It is generally considered to be a pharmacological effect. Patients show bone marrow suppression and megakaryocyte reduction, and the number of patients with mild asymptomatic disease can be as high as 25% taking this drug. Some pregnant women taking this drug may cause congenital thrombocytopenia in their newborns, but the mother may be asymptomatic.

4. Congenital megakaryocytosis: This disease is rare, with a significant decrease in megakaryocytes and platelets, often accompanied by congenital malformations such as those of the kidneys, heart, and bones. The prognosis is poor, and about 2/3 of children die from intracranial hemorrhage within 8 months. Rubella during pregnancy and oral administration of D860 may be the causes of the disease.

5. Others: Estrogen can occasionally cause amegakaryocytic thrombocytopenia. Ethanol can inhibit platelet production, which is a common cause of thrombocytopenia caused by long-term heavy drinking. There are few clinical bleeding symptoms, and platelets can recover after stopping drinking.