Positive effect

Immune thrombocytopenia. This form of the disease occurs as a result of increased destruction of platelets under the influence of antibodies. Ie in the patient's rights there is a state where its own blood platelets become as it were "strangers" or "unrecognizable" and as a consequence, the immune system, being constantly on guard, immediately produces against its own, but the "unrecognized" platelet antiplatelet antibodies.

This disease occurs in healthy people before this. A similar syndrome brand name viagra may be associated with chronic lymphocytic leukemia, lymphoma, systemic lupus erythematosus. Detectable at the level of platelet count often falls below 50,000 in 1 mm. Same number of megakaryocytes in the bone marrow remains normal or slightly elevated. It should be noted that the chronic form of the disease is noted, usually in adults and in this case is not always possible to identify provoking factor, but the acute form (immune thrombocytopenic purpura) develops most often in children 10-15 days after undergoing a viral infection. This form of the disease tends to spontaneously terminated within six months - usually within 5-6 weeks.

Immune thrombocytopenic purpura - is the most frequent violation of hemostasis in children. In chronic spontaneous remissions are rare, the vast majority of patients with complete or partial remission was observed either in the application of glucocorticoids, or after surgery - removal of the spleen (splenectomy). Glucocorticoid medications prescribed immediately after the detection of signs of thrombocytopenia. Dosages intentionally do not call, because the appointment of glucocorticoids is not the prerogative of the very sick man. To increase the platelet count in peripheral blood is needed, usually two-week therapy with glucocorticoids. And once the platelet count is more than 100000 in the 1 ml dose of glucocorticoid drug gradually reduced. Complete remission after treatment with glucocorticoids is seen in only a quarter of patients.

Removal of the spleen - splenectomy - holds patients who fail to achieve the desired effect of the use of glucocorticoids, or their use can give (have given) serious complications, or whether their application has given a temporary positive effect and thrombocytopenia recurs again and again. In response to numerous letters with questions and issues, statements such as: "My son (daughter, nephew, brother, etc.), our doctors offer surgery to remove the spleen, but we're not sure, should I?" (Or, "but we do not agree ") that's what I say - this operation is often life-saving-threatening bleeding, and I, as an experienced surgeon, I know many instances when relatives did not agree to perform this operation ...

Biting his elbows - it's in the spirit of our people, unfortunately. Usually after a splenectomy are experiencing a rapid rise of the platelet count. I can not say that splenectomy is not harmless and not a simple operation. This operation, once again, is performed only for health reasons - in case of bleeding that is resistant to conservative therapy. Before splenectomy pneumococcal vaccine is administered, and after it - klyukokortikoidnuyu continue therapy until normalization of platelet counts. And only then they were phased out.

After surgery, remission occurs in two thirds of patients with chronic form of Viagra a questionnaire international quality erection immune thrombocytopenia. Sometimes there are casuistic cases (as well as without them?). This is when after splenectomy - again a relapse and the reason is the presence of accessory spleen, which can be detected by isotopic methods. In these cases, removal of accessory spleen may lead to remission. Well, if the operation does not lead to success, and if after she retained severe thrombocytopenia with bleeding. Then show immunosuppressive - cyclophosphamide (Cyclophosphamide, Tsitoksan, Endoksan) or Vincristine long courses. In many patients, despite the low platelet count (sometimes even below 30,000 in 1 mm) no severe bleeding.

What do I do then? In such cases, long-term immunosuppressant therapy bezosonovatelna. I do not tire of repeating that the treatment of thrombocytopenia without a doctor - very dangerous. Sometimes the increase in the number of platelets in peripheral blood can cause long-term use antigonadotropnyh drugs (eg danazol, Danola, Danovala). Particularly effective use of the above drugs in people older than 45 years. In immune thrombocytopenia before the upcoming surgery or for severe bleeding platelet transfusion was shown. But the transfused platelets circulate in the long line - are rapidly destroyed. In these cases apply Immunoglobines. I repeat, I do not specify doses intentionally.

2. Diagnosis of drug thrombocytopenia is set on the basis of simultaneity of thrombocytopenic purpura and the reception of a particular drug. So what are the drugs most likely to be provocative? Here they are: antitumor agents, estrogens, thiazide diuretics, alcohol-containing means, quinidine, heparin, gold preparations, sulfanilaimidy. There is a long-standing rule which can not be ignored - in patients with thrombocytopenia of unknown origin should refuse to accept all medicines, except, of course, without which the patient's life is threatened. Thrombocytopenia often disappears after a few days after eliminating a drug provoke it, but can sometimes persist for several weeks and even months. For example, preparations of gold is very slowly eliminated from the body.

Using X-rays
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