Is thrombocytopenia serious?

Thrombocytopenia is a relatively common disease that needs to be taken seriously, because the causes of thrombocytopenia vary. The most common ones are viral infections, such as rubella, measles, and chickenpox. Chronic infection history can also cause symptoms of thrombocytopenia.

1. Causes of thrombocytopenia

1. Acute ITP often occurs during the recovery period of viral infection or upper respiratory tract infection, such as rubella, measles, chickenpox, parotid cancer, etc.

The patient's serum has a high level of antiviral antibodies, and the platelet surface-related antibodies are significantly increased, so it is believed that it is caused by viral antigens. The pathogenesis may be that the antigen-antibody complex including viral antigens cross-reacts with the platelet Fc receptor or the autoantibodies produced by viral antigens cross-react with the platelet membrane, damaging the platelets and being cleared by phagocytes.

2. There is often no history of prodromal infection before the onset of chronic ITP, which is caused by autoantibodies caused by changes in platelet structural antigens. 80% to 90% of the medical records contain platelet surface antibodies, of which 95% are PalgG, 2/3 are PalgG and PalgM, and a few are PalgA and pac. Antibodies act directly on the glycoproteins on the platelet membrane, and a few act on the Gbib complex, shortening the lifespan of platelets and changing their functions. Its content is negatively correlated with platelet lifespan, and it has been confirmed that the spleen is the main site of platelet antibody production.

2. Diagnosis of thrombocytopenia

1. Acute type: common in children, accounting for 90% of immune thrombocytopenia cases, with similar incidence rates in males and females. 84% of patients have a history of respiratory or other viral infection 1 to 3 weeks before onset. Therefore, the disease is most common in autumn and winter, with an acute onset and may be accompanied by fever, chills, and purpura of the skin and mucous membranes. If the patient has a headache or vomiting, be alert to the possibility of intracranial hemorrhage. The course of the disease is mostly self-limiting, with more than 80% of cases resolving on their own, and the average course of the disease is 4 to 6 weeks. A few cases may linger or become chronic over several years. The acute form accounts for less than 10% of ITP in adults.

2. Chronic type: common in young women, with the incidence rate in women being 3 to 4 times that in men. The onset is insidious, the symptoms are mild, and bleeding often recurs, with each episode lasting from several days to several months. The degree of bleeding is related to the platelet count. If the platelet count is >50×10^9/L, it is often bleeding after injury. If the platelet count is between (10 and 50)×10^9/L, there may be varying degrees of spontaneous bleeding. If the platelet count is less than 10×10^9/L, there is often severe bleeding. Except for the bleeding symptoms, the patient's general condition is good.