The causes of increase and decrease of platelets
Last reviewed: 19.10.2021
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An increase in the number of platelets in the blood (thrombocytosis) may be primary (the result of primary proliferation of megakaryocytes) and secondary, reactive, arising against a background of a disease.
An increase in the number of platelets in the blood can cause the following diseases.
- Primary thrombocytosis: essential thrombocythemia (platelet count may increase to 2000-4000 × 10 9 / L and more), erythremia, chronic myelogenous leukemia and myelofibrosis.
- Secondary thrombocytosis: acute rheumatic fever, rheumatoid arthritis, tuberculosis, liver cirrhosis, ulcerative colitis, osteomyelitis, amyloidosis, acute bleeding, carcinoma, lymphogranulomatosis, lymphoma, condition after splenectomy (for 2 months or more), acute hemolysis, after operations for 2 weeks).
Reduction in the number of platelets in the blood less than 180 × 10 9 / l (thrombocytopenia) is noted with oppression of megakaryocytopoiesis, a violation of platelet production. Thrombocytopenia can cause the following conditions and diseases.
Thrombocytopenia caused by a decrease in platelet formation (insufficiency of hematopoiesis).
- Purchased:
- idiopathic hematopoiesis hypoplasia;
- viral infections (viral hepatitis, adenoviruses);
- intoxication (mielodepressivnye chemicals and drugs, some antibiotics, uremia, liver disease) and ionizing oizuchenie;
- tumor diseases (acute leukemia, cancer metastases and sarcomas in the red bone marrow, myelofibrosis and osteomyelitis);
- megaloblastic anemia (deficiency of vitamin B 12 and folic acid);
- nocturnal paroxysmal hemoglobinuria.
- Hereditary:
- Fanconi syndrome;
- Wiskott-Aldrich syndrome;
- the May-Heglin anomaly;
- the Bernard-Soulier syndrome.
Thrombocytopenia caused by increased destruction of platelets.
- Autoimmune - idiopathic (Werlhof disease) and secondary [with systemic lupus erythematosus (SLE), chronic hepatitis, chronic lymphocytic leukemia, etc.], in newborns due to the penetration of maternal autoantibodies.
- Isoimmune (neonatal, posttransfusion).
- Gaptenovye (hypersensitivity to certain drugs).
- Associated with a viral infection.
- Associated with mechanical damage of platelets: with prosthetics of heart valves, extracorporeal circulation; with nocturnal paroxysmal hemoglobinuria (Marciafawa-Micheli's disease).
Thrombocytopenia caused by sequestration of platelets: sequestration in hemangioma, sequestration and destruction in the spleen (hypersplenism in Gaucher disease, Felty's syndrome, sarcoidosis, lymphoma, spleen tuberculosis, myeloproliferative diseases with splenomegaly, etc.).
Thrombocytopenia caused by increased consumption of platelets: disseminated intravascular coagulation (DVS) syndrome, thrombotic thrombocytopenic purpura, etc.
- The number of platelets in the blood, which requires correction:
- below 10-15 × 10 9 / l - in the absence of other risk factors for bleeding;
- below 20 × 10 9 / l - in the presence of other risk factors for bleeding;
- below 50 × 109 / l - with surgical interventions or bleeding.
Diseases and conditions accompanied by a change in MPV
|
Increase MPV |
Decrease MPV |
|
Idiopathic thrombocytopenic purpura Bernard-Soulier Syndrome May-Heglin anomaly Posthemorrhagic anemia |
Wiskott-Aldrich Syndrome |