From the Research
Thrombocytes, also known as platelets, are not causes but rather small cell fragments in the blood that play a crucial role in blood clotting. They are produced in the bone marrow from megakaryocytes and circulate in the bloodstream. When there is blood vessel damage, thrombocytes adhere to the injured site, activate, and aggregate to form a platelet plug, which is the first step in stopping bleeding. They also release chemicals that activate the coagulation cascade, leading to the formation of a fibrin clot. Abnormalities in platelet count or function can lead to bleeding disorders (if too few or dysfunctional) or thrombotic disorders (if too many or hyperactive). Normal platelet count ranges from 150,000 to 450,000 platelets per microliter of blood. Understanding thrombocytes is important because they are essential for hemostasis and are involved in various pathological conditions including thrombocytopenia, thrombocytosis, and platelet function disorders.
Pathophysiology of Thrombocytopenia
The pathogenesis of immune thrombocytopenia (ITP) is complex, involving alterations in humoral and cellular immunity, as noted in a study published in 2019 1. An abnormal proliferation of autoreactive T cells leading to the breakdown of immune tolerance to platelet antigens is suggested to be responsible for the up-regulated proliferation of autoantibody producing B cells. Consequently, the immune response induces enhanced T cell-mediated cytotoxicity and antibody-mediated platelet destruction through phagocytosis, complement activation, and apoptosis.
Clinical Relevance
Due to the central role of platelets in hemostasis, the clinical relevance of quantitative changes in platelet counts (< 150 G/l or > 450 G/l) may be significant, as discussed in a 2017 study 2. Thrombocytosis and thrombocytopenia can have various causes, including primary and secondary (reactive) reasons. Primary thrombocytosis occurs in myeloproliferative neoplasms, especially in essential thrombocythemia (ET), while secondary thrombocytosis can be caused by inflammation, infection, or other conditions. Thrombocytopenia, on the other hand, can be caused by immune disorders, bone marrow failure, or increased platelet destruction.
Diagnosis and Treatment
The diagnosis of thrombocytopenia or thrombocytosis involves a careful anamnesis, examination of the blood smear, and laboratory tests to rule out underlying conditions, as recommended in a 2017 study 2. Treatment of ITP typically involves corticosteroids as the first-line therapy, but other options such as thrombopoietin receptor agonists, rituximab, and splenectomy may be considered in refractory cases, as discussed in a 2021 study 3. The choice of treatment should be based on the individual patient's needs and response to therapy, with the goal of improving platelet count, preventing bleeding, and enhancing quality of life.