Thrombocyte Disorder

Allied Guru

Thrombocyte Disorder

Thrombocyte disorders wo conditions hain jo platelets (thrombocytes) ko affect karti hain, jo blood clots banane mein madad karte hain. Ye disorders ya toh platelet count ko kam karte hain (thrombocytopenia), ya platelet count ko zyada karte hain (thrombocytosis), ya phir platelet function ko impair karte hain, jisse abnormal bleeding ya clotting ho sakti hai.

Thrombocytopenia

Thrombocytopenia tab hoti hai jab platelet count normal range se kam ho jata hai, jo typically 150,000 platelets per microliter se kam hota hai. Thrombocytopenia kai reasons se ho sakti hai, aur symptoms ka severity platelet reduction ke degree par depend karti hai.

Thrombocytopenia ke Causes:

  • Decreased Platelet Production (Platelet Banane mein Kami):

    • Bone Marrow Disorders: Leukemia, myelodysplastic syndromes, aplastic anemia, ya myelofibrosis jaise conditions marrow mein platelets banane ki capacity ko reduce kar deti hain.

    • Viral Infections: HIV, Epstein-Barr virus (EBV), hepatitis, ya cytomegalovirus (CMV) jaise infections platelet production ko suppress karte hain.

    • Chemotherapy ya Radiation: Ye treatments bone marrow ko damage karte hain, jisse platelet production kam ho jata hai.

    • Nutritional Deficiencies: Vitamin B12 ya folic acid ki kami platelet production ko affect kar sakti hai.

  • Increased Platelet Destruction (Platelet Ka Zyada Destruction):

    • Immune-mediated Conditions (Autoimmune Diseases): Jaise immune thrombocytopenic purpura (ITP), jisme immune system apne hi platelets ko destroy kar leta hai.

    • Drug-induced Thrombocytopenia: Heparin, quinine, penicillin, aur sulfonamides jaise medications platelet destruction ka cause ban sakte hain.

    • Infections: Kuch infections, jaise dengue fever ya sepsis, platelet destruction ka reason ban sakte hain.

    • Disseminated Intravascular Coagulation (DIC): Ye condition jab hoti hai, to abnormal clotting ke wajah se platelets consume ho jate hain, jisse platelet count low ho jata hai.

  • Platelet Sequestration (Platelets Ka Spleen Mein Chala Jana):

    • Splenomegaly (Spleen ka Badha Hua Size): Jaise cirrhosis ya infections mein spleen badh jata hai aur zyada platelets ko apne andar store kar leta hai.

Thrombocytopenia ke Symptoms:

  • Bruising (asani se ya bina wajah ke chot lagna)

  • Petechiae (chhote laal ya purple spots jo skin pe dikhte hain)

  • Prolonged bleeding (koi chhoti si cutting ya surgery ke baad zyada bleeding hona)

  • Excessive bleeding during menstruation (female patients mein)

  • Gum bleeding ya nosebleeds

  • Fatigue ya weakness (severe cases mein)

Thrombocytosis 

Thrombocytosis ka matlab hota hai jab platelet count normal range se zyada hota hai, jo usually 450,000 platelets per microliter se upar hota hai. Ye primary (essential) aur secondary (reactive) types mein divide hoti hai.

Thrombocytosis ke Causes:

  • Primary Thrombocytosis (Essential Thrombocythemia):

    • Ye ek myeloproliferative disorder hai jisme bone marrow excess platelets produce karta hai bina kisi underlying cause ke. Ye JAK2, CALR, ya MPL genes ke mutations ki wajah se hota hai.

    • Isse thrombosis (blood clots ka banna) ka risk badh jata hai, jo stroke, heart attack, ya deep vein thrombosis (DVT) ka cause ban sakte hain.

    • Symptoms mild ho sakte hain, ya thrombotic events jaise:

      • Headaches

      • Dizziness

      • Chest pain

      • Visual disturbances

  • Secondary Thrombocytosis (Reactive Thrombocytosis):

    • Ye form kisi underlying condition ke wajah se hoti hai, jaise:

      • Infections: Bacterial, viral, ya fungal infections platelet production ko increase kar dete hain.

      • Inflammatory Disorders: Diseases jaise rheumatoid arthritis, inflammatory bowel disease (IBD), ya systemic lupus erythematosus (SLE) se platelets increase ho jate hain.

      • Iron Deficiency Anemia: Iron ki kami platelet production ko trigger kar sakti hai.

      • Surgical Recovery: Surgery ke baad platelet count zyada ho sakta hai.

      • Cancer: Kahi malignancies, specially GI tract ya lung cancers mein secondary thrombocytosis ho sakti hai.

Thrombocytosis ke Symptoms:

  • Thrombotic complications, jaise stroke, heart attack, ya deep vein thrombosis.

  • Fatigue

  • Headaches

  • Dizziness

  • Chest pain

  • Splenomegaly (kuch cases mein)

Platelet Dysfunction Disorders

Yeh disorders tab hoti hain jab platelets number mein normal hote hain, lekin unki function sahi nahi hoti, jisse proper clot nahi banta aur bleeding problems ho sakti hain.

Platelet Dysfunction ke Causes:

  • Inherited Platelet Dysfunction:

    • Glanzmann Thrombasthenia: Ek autosomal recessive disorder hai jisme platelets ke paas glycoprotein IIb/IIIa complex nahi hota, jo platelet aggregation ko impair karta hai.

    • Bernard-Soulier Syndrome: Ek aur autosomal recessive disorder hai, jisme platelets ke paas GPIb-IX-V complex nahi hota, jo platelets ko von Willebrand factor se bind karne mein help karta hai.

    • May-Hegglin Anomaly: Ek genetic condition jisme large platelets hote hain aur platelet function defective hota hai.

    • Storage Pool Disorders: Genetic defects jisme platelet granules mein abnormality hoti hai, jisse clotting factors like ADP aur serotonin release nahi ho pate.

  • Acquired Platelet Dysfunction:

    • Medications: Aspirin, NSAIDs, aur clopidogrel jaise drugs platelet function ko inhibit karte hain aur bleeding complications ka cause ban sakte hain.

    • Uremia: Kidney failure mein urea levels badhne se platelet function impair hota hai, jisse bleeding problems hoti hain.

    • Liver Disease: Chronic liver diseases, jaise cirrhosis, mein platelet dysfunction ho sakti hai kyunki liver se clotting factors kam bante hain.

    • Autoimmune Conditions: Jaise systemic lupus erythematosus (SLE), jisme circulating antibodies platelets ke against ho sakti hain aur platelet function ko affect karte hain.

Platelet Dysfunction ke Symptoms:

  • Easy bruising

  • Prolonged bleeding (cuts ya surgery ke baad zyada bleeding hona)

  • Epistaxis (nosebleeds)

  • Gingival bleeding (gums se bleeding hona)

  • Heavy menstrual periods (females mein)

  • Excessive bleeding after minor trauma

 

Laboratory Diagnosis 

Laboratory tests thrombocyte disorders diagnose karne ke liye bohot zaroori hote hain. Yeh tests platelet count, platelet function, aur underlying causes ko identify karte hain.

1. Complete Blood Count (CBC) with Platelet Count

  • Platelet Count: Ye test thrombocytopenia ya thrombocytosis ko diagnose karne ke liye sabse pehla step hai. Agar platelet count 150,000 se kam ho to thrombocytopenia hai, aur 450,000 se zyada ho to thrombocytosis.

  • Mean Platelet Volume (MPV): Platelets ka average size measure karta hai. Agar platelets bade hote hain, to zyada platelet production ho sakti hai, jo conditions like immune thrombocytopenic purpura (ITP) mein hota hai.

2. Peripheral Blood Smear

  • Blood smear se platelets aur dusre blood cells ka visual assessment hota hai. Thrombocytopenia mein giant platelets ya platelet clumps dekhe ja sakte hain.

  • Thrombocytosis mein, blood smear se abnormal platelet shapes ya sizes dikhayi de sakte hain.

3. Bone Marrow Aspiration/Biopsy

  • Agar bone marrow disorder (jaise leukemia, aplastic anemia, myelofibrosis) ka doubt ho, to bone marrow biopsy ki ja sakti hai. Yeh platelet production ko assess karta hai.

4. Platelet Function Tests

  • Platelet Aggregation Studies: Yeh test platelets ko different agonists jaise ADP, collagen, aur epinephrine ke sath react karne par evaluate karta hai. Agar aggregation defective ho to platelet dysfunction ho sakta hai.

  • PFA-100: Platelet function analyzer jo collagen aur epinephrine ke response mein platelet function ko evaluate karta hai. Ye bleeding disorders detect karne ke liye use hota hai.

5. Thromboelastography (TEG)

  • Is test se overall coagulation status ko assess kiya jata hai, including platelet function. Yeh real-time data provide karta hai ki clot kaise ban raha hai, uski strength kaisi hai, aur clot dissolve ho raha hai ya nahi.

6. Immunological Tests

  • Anti-platelet Antibody Tests: Immune thrombocytopenic purpura (ITP) ko diagnose karne ke liye use hota hai, jisme antibodies platelets ko target karti hain.

  • Flow Cytometry: Genetic platelet disorders like Glanzmann thrombasthenia ko diagnose karne ke liye use hota hai.

7. Coagulation Profile

  • PT, aPTT, aur fibrinogen levels ko measure karta hai. Yeh tests mainly clotting factors ko assess karte hain, lekin bleeding disorders ko rule out karne mein madadgar hain.

8. Genetic Testing

  • Genetic testing se inherited platelet dysfunctions jaise Glanzmann thrombasthenia ya Bernard-Soulier syndrome ka diagnosis confirm ho sakta hai.