Treatment of thrombocytopenia

Treatment of thrombocytopenia is recommended to begin after a hematological examination.

Mostly, it is difficult to establish the exact cause of this disease, or the factors that led to its occurrence are not important for drawing up a plan of treatment measures. This is justified by the fact that treatment measures can be oriented both against thrombocytopenia itself and aimed at the disease in which it acts as a concomitant disease.

Diagnosis of thrombopenia involves laboratory blood tests during a course of treatment using corticosteroids. In addition, genetic testing methods are used, as well as antibody tests. The patient must undergo a series of tests, including an electrocardiogram, radiography, and endoscopic examination.

A particular program of necessary treatment measures for thrombopenia is determined depending on what general standards exist in the treatment of the underlying disease. Thus, Werlhof's disease, which is a chronic immunopathological thrombopenic purpura (purpura is a capillary hemorrhage of a small-spotted nature in the mucous membranes or under the skin), requires surgical intervention to remove the spleen. Splenectomy leads to a positive result in 80% of cases. If this surgical treatment is ineffective, a course of chemotherapy is prescribed, or immunoglobulins may be prescribed. In some cases, plasmapherosis may be justified before starting hormonal therapy.

As a rule, treatment of thrombocytopenia, starting from examination and diagnosis, determining the appropriateness of using certain treatment measures, to the actual course of therapy, takes a period of time from two months to six months. After completion of the course, the patient must be under dispensary observation.

Treatment of thrombocytopenia with folk remedies

Due to the fact that this disease is a hemorrhagic diathesis, treatment of thrombocytopenia with folk remedies mainly comes down to the use of all kinds of collections with hemostatic properties.

In cases of gastric, uterine and renal bleeding, as well as intestinal bleeding, traditional medicine recommends medicinal burnet. A decoction of this perennial herb, also called medicinal burnet or glandular burnet, produces an astringent effect. To prepare, boil its crushed roots in the amount of 2 tablespoons with 250 ml of water over low heat for 15 to 20 minutes. Take with one teaspoon of jam.

For bleeding of all types, a positive result can be achieved by using stinging nettle. This folk remedy is prepared as follows. 1 tbsp. of dry leaves per 250 ml. of boiling water should be boiled for 10 minutes over low heat, then allowed to cool and then strained. It should be taken in the amount of 2 tbsp. spoons 4-5 times throughout the day.

A wonderful folk remedy that helps with all types of bleeding is viburnum bark. Four teaspoons of crushed bark per 300 ml of boiling water are boiled over low heat for 30 minutes, after which it is necessary to strain and take two tablespoons 3 to 4 times a day.

Thrombopenia is treated with folk remedies also using a collection of herbs. It is necessary to mix flowers and leaves of shepherd's purse, yarrow and dry cucumber vines, 25 grams of each of these components. One tablespoon of the resulting mixture per 0.5 liters of boiling water is brewed for 5-6 hours. Take three times a day 20 minutes before meals, in an amount of 150 to 180 ml.

Treatment of thrombocytopenia with folk remedies can lead to a positive result and be quite an effective way to combat this disease, if it is not characterized by a significant degree of severity. However, it should not be forgotten that before using such treatment measures, it is necessary to consult a medical specialist.

Treatment of thrombocytopenia with herbs

Thrombopenia in its severe forms requires treatment aimed at eliminating the agent subject to damage, which means the need to establish the causes and cure the underlying disease. Mild forms of thrombopenia, in which clinical manifestations are not observed, generally do not require therapy, only regular medical monitoring of the course of the disease is necessary. An example of this is thrombopenia in women during pregnancy, which is characterized by a tendency to spontaneous healing after childbirth.

In mild forms of this disease, not associated with the need for any significant and radical medical measures: therapy or surgery, various folk methods can be effective, in particular, the treatment of thrombocytopenia with herbs. The essence of herbal medicine in this case is that by using certain plant-based products it becomes possible to achieve an improvement in blood characteristics. First of all, this concerns its coagulability. In this regard, the healing properties of nettle, rose hips, and yarrow are especially useful.

A decoction is prepared from the leaves of stinging nettle. Three tablespoons of nettle per glass of boiling water are brewed and infused for 10 minutes, then it is necessary to strain and leave to cool. It should be taken three to four times a day.

Rose hips and strawberries in the amount of one tablespoon of each of the components are poured with 250 ml of boiling water. After it has been infused for a quarter of an hour, the infusion is filtered and taken half a glass three times during the day.

A healing remedy made from yarrow is prepared as follows. Two tablespoons of it are infused for half an hour in 250 ml of boiling water. Then the infusion is filtered and taken three times a day, one tablespoon at a time.

Thus, the treatment of thrombocytopenia with herbs is aimed, first of all, at promoting the normalization of blood parameters, improving its coagulation properties, and in addition, the use of certain herbs is recommended in cases where anemia develops against the background of the disease.

Treatment of thrombocytopenia with prednisolone

Treatment of thrombocytopenia with prednisolone is the main method of symptomatic therapy of this blood disease. Prednisolone is a hormonal drug of the steroid group, and its use is characterized by a beneficial effect on the prognosis of the course of the disease, since it helps to achieve a positive effect already during the first week of use. In the period from 7 to 10 days of such therapy, the disappearance of hemorrhagic rashes is noted, and after some time, the number of platelets in the blood normalizes.

The initial dosage for prednisolone therapy is 1-2 mg/kg per day. As the platelet count in the blood begins to increase, the dose is gradually reduced after the 2nd or 3rd week of therapy. In order to maintain the platelet count within the normal range, a 10-20 percent reduction in dose per week is allowed. As a result, more than half of patients experience a positive effect, and remission occurs in 25 percent of cases.

If the use of the drug is not effective enough, side effects are observed, or in cases where high doses of prednisolone are required, immunoglobulins are prescribed for intravenous administration. This is done in a daily dosage of 0.4 g / kg for five days.

Treatment of thrombocytopenia with prednisolone is justified when the hemorrhagic syndrome begins to show a tendency to increase in intensity, if hemorrhages occur in the conjunctiva, rashes appear on the face and on the mucous membranes in the oral cavity. And in addition, the reason for the need for such treatment measures is a decrease in the content of blood platelets in the blood to a critically low level - less than 20,000 / μl. In cases where there is no likelihood of hemorrhage in the cranial cavity or bleeding of the mucous membranes, a wait-and-see tactic is chosen.

Treatment of thrombocytopenia in children

Thrombopenia is a disease that mainly occurs in preschool children. The incidence of this disease in boys and girls is approximately the same. The highest probability of developing such an ailment occurs in the winter-spring period, in the off-season of winter and spring. Risk factors associated with the possibility of thrombopenia in a child are considered to be recent diseases such as chickenpox, measles, rubella, Epstein-Barr virus, etc. In addition, there is a possibility that the disease can develop as a result of vaccination against the above pathogens. To date, it is still impossible to explain with complete certainty what exactly causes this disease. It is suggested that thrombopenia is one of the immune reactions to the appearance of foreign substances in the body, in which antibody-antigen complexes are formed.

The presence of the disease is indicated by the appearance of pinpoint hemorrhages under the skin, frequent nosebleeds, and bleeding gums. The most dangerous are intracranial and internal organ hemorrhages.

Treatment of thrombocytopenia in children begins after further studies necessary to establish an accurate diagnosis. The main role in diagnosing thrombocytopenia in a child is played by both a thorough laboratory blood test and a visual assessment of its cells through a microscope. In some cases, an ultrasound examination reveals that the spleen is hypertrophied. In a relapse situation, as well as when the course of the disease is protracted - from 3 months to six months, it may be necessary to perform a bone marrow puncture.

Treatment is carried out by transfusing platelets from a donor, which makes it possible to correct the progress of the disease. In the event of hemorrhages and rashes on the face and mucous membranes, steroid therapy is immediately started. A positive result from it begins to appear after a period of one week to 10 days.

In order for the treatment of thrombocytopenia in children to be effective, and the prognosis for the development of the disease to be favorable and its presence not to pose a threat to the life and development of the child, it is very important, having identified the initial symptoms, to conduct the necessary examinations and diagnostics, based on the results of which to begin implementing the necessary treatment measures.

Treatment of thrombocytopenia during pregnancy

Treatment of thrombocytopenia during pregnancy should be carried out without fail if the blood counts are characterized by a level of platelets lower than 20-40*10 ⁹ per l. Another important condition in addition to the treatment of the underlying disease that caused the decrease in the number of platelets in the blood is the need to combine it with the maintenance of the homeostasis system.

A course of therapy is prescribed using dexamethasone, prednisolone - drugs of the glucocorticosteroid group. Their use in the late stages of pregnancy, among other things, acts as a positive factor contributing to the acceleration of the process of lung formation in the future child. Based on this circumstance, if there are appropriate indications, a decision can be made on early resolution of childbirth. Glucocorticosteroids are used for short courses, gradually reducing their doses as the clinical effect is achieved.

In cases where corticosteroids have proven to be insufficiently effective during the entire period of their use, it may be advisable to administer immunoglobulin intravenously. During the entire period in which a woman is carrying a child, its administration is allowed 3-4 times, and subsequently - during childbirth and immediately after them. Platelet mass during pregnancy is transfused only in urgent, extremely exceptional cases.

Ineffectiveness of drug treatment may necessitate splenectomy, removal of the spleen. During pregnancy, such surgical intervention is allowed during the second trimester, and the optimal method for this is laparoscopic surgery.

To summarize how thrombocytopenia can be treated during pregnancy, we note that a woman's health during the period when she is preparing to experience the joys of motherhood requires extremely close attention, and it is necessary to carefully analyze many factors so that drug effects and other therapeutic manipulations do not harm the baby. It is necessary to calculate the dosage of drugs based on this, and it is advisable to choose the methods of surgical intervention in favor of the one that is associated with the least possibility of damage to the body of the expectant mother (laparoscopy) and harm to her baby.

Treatment of autoimmune thrombocytopenia

Autoimmune thrombocytopenia is also called idiopathic thrombocytopenia or Werlhof's disease. In this disease, each platelet in the blood is identified by the body as a foreign body. Under the influence of autoantibodies produced by the lymph nodes, liver and spleen, the platelets in the blood become less than the normal values.

Treatment of autoimmune thrombocytopenia is regulated by certain principles and rules, as well as the sequence and extent of application of certain medical interventions and measures that are appropriate at each specific stage of the disease's progression.

Prednisolone is prescribed first, at an initial dosage of 1 mg/kg per day. If the disease is more severe, the dose may be increased by an amount not exceeding the initial dose by more than twice as much as possible. After several days of glucocorticosteroid use, a tendency toward a decrease in the severity of symptoms is noted. The satisfactory effect achieved serves as a basis for gradually reducing the dose until the drug is discontinued.

Sometimes the therapy does not lead to a positive result or relapses may occur. This may necessitate surgery to remove the spleen. Such removal or splenectomy provides a 75% chance of curing the patient. In some cases, the patient's condition may return to normal within the next six months, which is a delayed effect of the surgery.

If, as a result of a course of prednisolone and subsequently removal of the spleen, no positive changes are observed in the patient’s condition, treatment continues with the use of glucocorticosteroids and cytostatic immunosuppressants.

Thus, the treatment of autoimmune thrombocytopenia is a rather complex process that requires all its stages to be built in a certain sequence. For example, immunosuppressants prescribed before the spleen is removed will negatively affect the possibility of successful performance of such an operation.

Treatment of secondary thrombocytopenia

Secondary thrombopenia may occur as a result of the body being exposed to radiological influence – in this case it acts as one of the symptoms of radiation sickness. In addition, the cause of such a disease can be poisoning of the body with various toxic substances, including salts of heavy metals, alcohol, etc. At the same time, this nosology is included in the set of symptoms that characterize pancytopenia. This disease can also occur with uremia.

Secondary thrombocytopenia occurs due to the harmful effects of various toxins on the bone marrow: gasoline with its derivatives - varnishes, pesticides, organic solvents, and in addition to this, due to the entry of bacterial poisons into the body, and mainly viruses: chickenpox, infectious mononucleosis, measles, scarlet fever, etc. This blood disease can also be provoked by the use of drugs with cytostatic action.

Diagnostics and treatment of secondary thrombocytopenia is carried out with the patient who needs to be in a hospital setting for this. After conducting a comprehensive laboratory and diagnostic examination, appropriate therapy is prescribed. The plan of medical measures is drawn up in such a way as to subject the main cause that led to the progress of thrombocytopenia to targeted therapeutic action. And in addition, the therapy of this disease involves the direction of therapeutic measures against the initial pathological processes and phenomena in the patient's body, which caused secondary thrombocytopenia.

Since this blood disease is mainly one of the symptom complex of the main disease, the treatment of secondary thrombocytopenia is mainly reduced to the use of therapeutic and preventive measures aimed at its healing. Prevention is of great importance. It is aimed at avoiding the impact of factors that cause damage to the bone marrow and, as a result, lead to pathological transformations of megakaryocytes, which are the precursors of blood platelets.

Treatment of thrombocytopenia after chemotherapy

Thrombopenia is a complication, one of the most dangerous arising against the background of chemotherapy. The disease is characterized by a tendency to a significant decrease in the number of platelets, which in turn manifests itself in the deterioration of blood clotting. Because of this, bleeding of varying intensity occurs, which leads to the need to shorten the courses of chemotherapeutic drugs, or makes their use impossible. To increase the level of platelets, the deficiency of which leads to the detrimental effect on the blood composition of chemicals used in chemotherapy, various medications can be prescribed.

Treatment of thrombocytopenia after chemotherapy is carried out using dexamethasone, prednisolone, etc., which are hormonal drugs that are included in the prescription sheet from the very beginning of the course of chemotherapy. They have a positive effect on strengthening the vascular walls and help increase blood clotting. A similar beneficial effect is observed when using Derinat, the basis for the production of which is nucleic acids contained in salmon. The drug that has a positive effect on the composition of the blood and has strengthening properties for the walls of blood vessels is etamsylate.

Prednisolone. The drug is available in tablets, ointments, and 1 ml ampoules, 3 per package. Prescribed at 1-2 mg/kg per day, or at a daily dosage of 60 mg/m2 for three weeks, gradually reducing the dose until complete withdrawal. Long-term use of the drug is associated with the possibility of obesity, excessive hair growth in women on the body and face, menstrual irregularities, osteoporosis, increased glycemic index, etc.

Dexamethasone is used for thrombocytopenia if prednisolone is ineffective. It is available in tablets, drops, and as an injection solution in 1 ml ampoules. The number of ampoules in a package may vary from 5 to 10. The drug is administered in several courses (no more than 4) of 0.6 mg/kg intravenously during the day, or 20 mg/m2 for 4 days every two weeks. Side effects may include tachycardia and baricardia, angina attacks, arterial hypertension, increased intracranial and intraocular pressure, rhombophlebitis, and eosinophilia.

Derinat is a solution for external or local use, another form of release is a solution for injections in a bottle of 5 or 10 ml, 1.5% and 0.25%, respectively. The drug is administered intramuscularly (it should be administered over 1-2 minutes) in a dose of 5 ml (75 mg) of a 1.5% solution with a break of 24 to 72 hours. The drug is well tolerated by patients. But pain is possible from one and a half to three hours after injection. Sometimes there is an increase in temperature to 380C, which does not require discontinuing use.

Etamzilat is a tablet, packed in a blister in the amount of 10 or 50 pieces. It is taken orally three to four times a day, during or after meals. The use of the drug can provoke symptoms such as headache, nausea, vomiting, cause allergies, skin rashes.

Treatment of thrombocytopenia after chemotherapy is carried out using a variety of medications and is aimed at bringing the blood composition, including the platelet content, which has undergone changes due to the effect of active chemicals during appropriate therapy, to an optimal state.