What to do if platelet count is 0

A platelet count of 0 can be said to be a particularly dangerous symptom, because it is likely a manifestation of white blood cells, and may also be caused by aplastic anemia. No matter which symptom it is, it will pose a certain threat to the patient's health, so it needs to be actively treated through certain methods. So, what are the ways to treat platelet count of 0? The following will introduce relevant knowledge to you!

1. Transfusion of fresh blood or platelets

It should only be used as an emergency treatment for severe bleeding. Because of the presence of antiplatelet antibodies in the patient's blood, the transfused platelets can be destroyed quickly and have a short lifespan (minutes to hours). Therefore, blood transfusion or platelet transfusion cannot effectively increase the platelet count. However, some people believe that platelet transfusion can quickly reduce capillary fragility and alleviate bleeding tendency.

2. Adrenal cortex hormone

It is generally believed that the therapeutic effect of hormones is due to: ① reducing capillary permeability and reducing bleeding tendency; ② reducing immune response, reducing the production of PAIgG and inhibiting the phagocytosis of antibody-attached platelets by splenic mononuclear macrophages. Therefore, after the early application of large amounts of hormones in ITP patients, bleeding symptoms can improve quickly. It is still advocated that patients whose condition is moderate or above within 1 month of onset (especially within 2 weeks) or whose condition is severe or above despite a long duration of onset should be given hormone treatment. The principles of medication are early, large-scale, and short-term. Generally, prednisone 60 mg/m2·d (2 mg/kg·d) is taken orally in 2 to 3 times or once in the early morning.

If the bleeding is severe, prednisone can be taken orally at a dose of up to 120 mg/m2·d, or hydrocortisone 400 mg/m2·d or flumethasone 10-15 mg/m2·d can be given by intravenous drip. When the bleeding improves, the dose can be changed to prednisone 60. g/m2·d. The medication is generally used for about 3 weeks, no longer than 4 weeks, and the dosage is gradually reduced until it is stopped. Even if the platelet count drops after stopping the medication, as long as the bleeding is not obvious, you can continue to observe and no longer use hormones. If extensive bleeding occurs again, hormone treatment is still needed. After the bleeding improves, the medication can be changed to every other day or maintained with only a small dose to prevent bleeding. Beijing Children's Hospital uses dexamethasone 1 mg/kg/d intravenous drip shock therapy for acute and critically ill children, reducing the dose by 1/4 every 3 to 4 days.

Three weeks later, the treatment was changed to oral prednisone 40-60 mg/m2·d, which achieved better results. Avoid long-term use of adrenal cortex hormones. Chronic patients need to take sufficient medication for 3 to 4 weeks, and the bleeding will stop and the dosage can be reduced. When the platelet count rises to 50×109/L, the medication can be stopped and observed.

3. High-dose immunoglobulin intravenous injection

For children with severe or above bleeding, large doses of purified immunoglobulin (IgG) can be given intravenously, about 0.4 g/kg·d, for 5 consecutive days. The platelet count can be increased in about 70% to 80% of patients, especially for chronic patients, which tends to temporarily replace splenectomy. However, this kind of refined product is expensive and difficult to promote at the moment.