Thrombocytosis
Contents:
Description:
Thrombocytosis (thrombocytosis; a thrombocyte[s] + - Usis) — the increased maintenance of thrombocytes in blood. Distinguish primary (idiopathic) and secondary (symptomatic) thrombocytosis.)
Thrombocytosis symptoms:
Primary thrombocytosis (primary trombotsitemiya) belongs to myeloproliferative diseases, is clinically shown by sharp increase in blood of quantity of thrombocytes and development of a trombogemorragichesky syndrome. Disturbances of microcirculation, aggregation ability of thrombocytes (tendency of thrombocytes to aggregation increases), development of the disseminated intravascular blood coagulation with consumption of factors of a hemostasis are its cornerstone. Are ill with an identical frequency of the man and woman, is more often at the age of 50 — 60 years. At patients nasal, uterine, gastrointestinal, renal and other bleedings, ecchymomas, hypodermic hemorrhages, a cyanotic shade of skin are noted; the itch, severe pains in finger-tips of hands and legs are characteristic; the gangrenosis is possible. Activity disturbances ц.н.с can be observed. and kidneys, and also fibrinferments of large blood vessels, are more often than veins (portal, splenic, hepatic, etc.), but formation of blood clots can happen also in arteries (mesenteric, sleepy, coronal, brain, pulmonary, etc.). In blood the thrombocytosis is expressed (800 — 1200×109/л and more). In blood smears thrombocytes form large units. Existence of huge thrombocytes, and also thrombocytes with the changed form and vacuolation is typical; megacaryocytes or their fragments can be found. The quantity of leukocytes usually increases moderately (10 — 15×109/л); the leukocytic formula often does not change though the shift to the left to myelocytes is possible. At some patients the quantity of erythrocytes is slightly increased and the hemoglobin content is raised. At repeated bleedings development of an iron deficiency anemia is possible. At a marrow research in a trepanobioptata, as a rule, there is no expressed trekhrostkovy myeloid hyperplasia; increase in quantity of megacaryocytes is observed (more than 5 — 6 under review). In some cases the myelofibrosis can come to light. The spleen at most of patients is a little increased.
Secondary thrombocytosis meets at physiological (the physical tension, a hyperadrenalemia) and morbid conditions of an organism.
Thrombocytosis reasons:
The thrombocytosis has the polyetiological nature. It can have the myeloproliferative beginning. Also the thrombocytosis meets at physiological (the physical tension, a hyperadrenalemia) and morbid conditions of an organism. The symptomatic thrombocytosis is possible after bleedings, hemolitic crises, after removal of a spleen, and also at inflammatory diseases (for example, at tuberculosis, rheumatism), malignant new growths, a myelosis, an Osler's disease, an osteomyelofibrosis, cirrhosis, a polycystosis of kidneys, Itsenko's disease — Cushing. Usually at a secondary thrombocytosis the quantity of thrombocytes seldom exceeds 1000×109/л, the morphology and their function are, as a rule, not changed.
Treatment of the Thrombocytosis:
Treatment of primary thrombocytosis is carried out by Myelosanum, miyelobromoly and other cytostatic drugs within several weeks to normalization of quantity of thrombocytes. At disturbances of microcirculation antiagregant appoint (acetylsalicylic acid, trental, etc.). In some cases the disease a long time can proceed without the expressed clinical symptomatology (with a small thrombocytosis and without trombogemorragichesky complications), at the same time treatment is not required. The forecast is rather favorable.
