Bone marrow failure and thrombocytopenia

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Platelets are blood cells produced by the bone marrow that stop bleeding by causing blood to clot and coagulate when a vessel is injured. Therefore, if due to some cause, thrombocytopenia will seriously affect the body's ability to stop bleeding characterized by an increased risk of bleeding.

1. What is thrombocytopenia?

Thrombocytopenia is defined as when the peripheral platelet count is less than 150000 cells/mL. Thrombocytopenia can be caused by 3 groups of causes:
Decreased platelet production is often associated with problems in the bone marrow such as: bone marrow failure, blood malignancies, bone metastases, bleeding, thrombocytopenia , viral infection, drug-induced aplastic anemia. Increased consumption and destruction of platelets: Consumptive coagulopathy, thrombocytopenic purpura, systemic lupus erythematosus, blood transfusion and organ transplantation, HELLP syndrome, disseminated intravascular coagulation, vasculitis or injury or blood, artificial heart valve, severe infection. Increased arrest of platelets in the spleen due to splenomegaly is seen in cirrhosis, hepatitis, blood cancer, neonatal thrombocytopenia.

2. Manifestations of thrombocytopenia

For patients with mild thrombocytopenia, there are often no symptoms but only incidentally detected through blood tests. However, when thrombocytopenia is severe (less than 20000 cells/mL, there may be symptoms of prolonged bleeding when the hand is cut, or heavy bleeding during menstruation. platelets/mL), the patient may bleed spontaneously, manifested by hemorrhages in the subcutaneous tissue, oral mucosa, gastrointestinal tract mucosa, nasal mucosa, pharynx, and pharynx (nosebleed).

Platelet hemorrhagic nodules are small, red, flat, pinhead-sized hemorrhages observed under the skin of the lower body (legs) due to increased pressure due to gravity. This is the result of bleeding in the capillaries under the skin or mucous membranes. In addition, thrombocytopenic purpura is a subcutaneous purpura of more than 3 mm in diameter, possibly due to a convergence of purpura.

3. Thrombocytopenia due to bone marrow failure

Bone marrow failure is a clinical syndrome manifested by a decrease in red blood cells, white blood cells, and platelets in the blood, while the bone marrow is replaced by adipose tissue and decreased hematopoietic progenitor cells. Thus, this is a cause of decreased production, causing a decrease in peripheral platelet cells, causing patients to have signs of bleeding under the skin, bleeding of the oral mucosa or menorrhagia.
For the treatment of patients with thrombocytopenia due to bone marrow failure, the following principles of treatment should be followed:
Treat the cause: Isolate the patient from the environment suspected of being the main cause of the disease or discontinue the drugs that cause the disease. can cause bone marrow depression. Supportive therapy: Maintain platelets at 10 K/μL, platelet transfusion only in the presence of systemic infection. If antiplatelet therapy is due to long-term infusion, high-dose intravenous gamma globulin may be used. For patients who do not have a bone marrow transplant, it is best to transfuse platelets from a relative. Specific treatment: bone marrow transplant, use of immunosuppressive drugs. Bone marrow failure and thrombocytopenia are both dangerous medical conditions that need to be examined and found the cause for early detection. To detect the disease, you can have regular health check-ups, if you have a medical history, you need a general health check-up to detect the disease and get timely treatment.

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