secondary thrombocytosis
Introduction
Introduction to secondary thrombocytosis Secondary thrombocytosis is mainly seen in chronic infection, malignant tumor, acute blood loss, hemolytic anemia, response to surgical drugs, and excessive platelet production caused by connective tissue disease. It is generally asymptomatic. Some patients may have thrombosis and peripheral platelets are higher. Normal >400 × 109 / L, you can diagnose. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: thrombosis
Cause
Cause of secondary thrombocytosis
(1) Causes of the disease
Secondary thrombocytopenia can be found in many diseases or physiological conditions and can be classified as follows: malignant tumors (including hematological malignancies); chronic inflammation (connective tissue disease, tuberculosis, cirrhosis, chronic pancreatitis, chronic pneumonia, arteritis) Acute inflammatory infection; acute blood loss; iron deficiency anemia; hemolytic anemia; surgery (spleen resection and other surgical procedures); drug reaction (vincristine, adrenaline, interleukin-1); exercise response; recovery after thrombocytopenia Rebound) (discontinuation of myelosuppressive drugs, alcohol, after VitBl2 deficiency treatment); other (premature infants, infant VitE deficiency, osteoporosis, heart disease, kidney transplantation, diabetes insipidus, pregnancy, kidney failure).
Among the above causes, malignant tumors, surgery, iron deficiency anemia and connective tissue diseases are more common.
(two) pathogenesis
The majority of thrombocytopenia in patients with secondary thrombocytopenia is due to the acceleration of platelet production. The mechanism of platelet overproduction caused by various diseases remains unclear. Because platelet production is regulated by hematopoietic factors, thrombocytosis is at least partially related to interleukin-1. Interleukin-2, interleukin-3, interleukin-6 and interleukin-11 are involved in the release of factors such as adrenaline, which release platelets from the storage site and cause thrombocytosis. The absence of platelets in the spleen does not increase the release from the spleen. Platelets are released and platelets are increased, but those without spleen also find thrombocytosis after exercise.
Platelet life is normal or reduced, platelet function tests include platelet aggregation induced by various inducers, platelet factor 3 release and bleeding time are often normal.
Thrombosis is caused by an increase in the number of platelets, which may be related to the spontaneous aggregation of a large number of platelets occurring in the blood vessels, which is associated with abnormal blood platelet clotting activity with a large increase in platelets.
Prevention
Secondary thrombocytopenia prevention
1. Preventive medication: such as oral enteric-coated aspirin, dipyridamole (Pan Shengding), regular infusion of compound Danshen injection.
2. Actively treat the primary disease and avoid the increase of platelets.
Complication
Secondary thrombocytopenia complications Complications thrombosis
Thrombosis and hemorrhage in important organs are often the main cause of death in this disease.
Symptom
Symptoms of secondary thrombocytosis common symptoms atherosclerosis thrombocytosis high viscosity syndrome erythrocytosis - high viscosity
Generally asymptomatic, thrombosis can occur in a small number of patients: elderly patients, atherosclerosis, thrombosis, inactive patients, bleeding abnormalities are rare.
The platelet count is higher than 400×109/L and it is confirmed that the disease can be diagnosed by the primary disease. The platelet count of patients with secondary thrombocytosis is generally less than 1000×109/L.
Examine
Examination of secondary thrombocytosis
Peripheral blood
Platelet morphology, function and survival time are generally normal, and platelet counts are mostly above 400-1000×109/L.
2. Bone marrow megakaryocytes are slightly hyperplasia.
3. Fibrinogen levels can be elevated, which may be an acute phase of the primary disease, which may contribute to the identification of essential thrombocytosis.
4. Serum acid phosphatase and potassium may increase, but the plasma is normal.
According to clinical manifestations, symptoms, signs, X-ray, B-ultrasound, electrocardiogram, etc.
Diagnosis
Diagnosis and diagnosis of secondary thrombocytosis
Peripheral platelets above the normal >400 × 109 / L, can be diagnosed.
Differential diagnosis
Identification with essential thrombocytosis. The identification of cases with long-term significant increase in platelet count after splenectomy and primary thrombocytosis is sometimes difficult.
