prone to bruising
Introduction
Introduction The symptoms of leukemia are mainly related to the destruction of hematopoietic function in the bone marrow. Symptoms caused by destruction of bone marrow hematopoietic function are prone to bruising, spotted hemorrhage: a decrease in megakaryocytes resulting from the production of platelets, resulting in a lack of platelets. Leukemia is a type of malignant clonal disease of hematopoietic stem cells. Clonal leukemia cells proliferate and accumulate in bone marrow and other hematopoietic tissues due to uncontrolled proliferation, differentiation disorders, and blocked apoptosis, and infiltrate other tissues and organs, while normal hematopoiesis is inhibited. Clinically, varying degrees of anemia, hemorrhage, infection, fever, and swelling of the liver, spleen, lymph nodes, and bone pain can be seen.
Cause
Cause
Viral factor
The leukemia effect of RNA tumor viruses in animals such as mice, cats, chickens and cattle has been confirmed, and leukemias caused by such viruses are mostly T cell types.
2. Chemical factors
Some chemicals have a leukemia effect. The incidence of leukemia in people exposed to benzene and its derivatives is higher than in the general population. Reports of nitrosamines, phenylbutazone and its derivatives, chloramphenicol and other induced leukemias are also available, but statistics are still lacking. Certain anti-tumor cytotoxic drugs such as nitrogen mustard, cyclophosphamide, procarbazine, VP16, VM26, etc., are recognized as having leukemia.
3. Radiation factors
Including X-rays, r-rays. There is definite evidence to confirm that various ionizing radiation conditions can cause human leukemia. The occurrence of leukemia depends on the dose of radiation absorbed by the body, and the whole body or part of the body can induce leukemia after being exposed to medium or large doses of radiation. However, whether small doses of radiation can cause leukemia remains uncertain. After the bombing of atomic bombs in Hiroshima and Nagasaki, Japan, the incidence of leukemia in severely irradiated areas is 17 to 30 times that of unexposed areas. Three years after the explosion, the incidence of leukemia increased year by year, reaching a peak at 5 to 7 years. After 21 years, its incidence has returned to a level close to that of Japan. Radiation workers, radioactive substances (such as cobalt-60) are often exposed to a significant increase in the incidence of leukemia. Radiation diagnosis and treatment can lead to an increase in the incidence of leukemia.
4. Genetic factors
The incidence of leukemia in people with chromosomal aberrations is higher than in normal people.
5. Other blood diseases: Some blood diseases may eventually develop into leukemia, such as myelodysplastic syndrome, lymphoma, multiple myeloma, paroxysmal nocturnal hemoglobinuria.
Examine
an examination
Related inspection
Blood biochemistry six examination blood routine
1. Symptoms and signs
(1) Fever: Most of the fever is caused by infection.
(2) Bleeding: There may be bleeding of the skin and mucous membranes in the early stage; followed by visceral hemorrhage or concurrent disseminated intravascular coagulation.
(3) Anemia: Progressive aggravation.
(4) Leukemia cell proliferation and infiltration performance:
1) Liver, spleen, and lymph node enlargement: T cell ALL is often accompanied by mediastinal lymphadenopathy.
2) Osteoarthritis pain: sternal tenderness is one of the common symptoms.
3) Nervous system leukemia: occurs mostly in the remission period of leukemia, and ALL has a higher incidence than AML.
4) Testicles: mostly unilateral testicular painless swelling.
2. Blood cell count and classification: Most patients have anemia, mostly moderate to severe; the majority of white blood cells are increased, blood smears can be seen in different numbers of leukemia cells; platelet counts are mostly less than normal.
3. Biochemical examination: serum uric acid concentration increased, and some patients had elevated lactate dehydrogenase (LDH).
4. Bone marrow examination: morphology, biopsy (if necessary).
5. Immunophenotyping: According to immunophenotyping, ALL is divided into precursor B cell ALL, mature B cell ALL and T cell ALL.
6. Cytogenetics: Karyotype analysis, FISH (if necessary).
7. Perform molecular biology testing when conditions permit.
Diagnosis
Differential diagnosis
Painful femoral bruising: When the iliac crest and femoral vein thrombosis, extensively involving the intramuscular venous plexus, the iliac vein and its collaterals are all blocked by the thrombus, and the lower extremities are highly edematous. Due to severe venous return disorder, severe congestion, clinical manifestations of severe pain, the skin of the affected limb is purplish, often accompanied by arterial spasm, lower extremity arterial pulsation weakened or disappeared, skin temperature decreased, and then high circulation disorder, becoming an emergency for lower extremity DVT State, systemic reaction is large, prone to shock and wet gangrene of lower limbs.
