Sickle Cell Disease (SCD): Practice Essentials, Background, Genetics



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What To Know About Low Platelet Counts In Lupus

Lupus may cause you to experience low platelet counts. This could be a direct result of the disease or due to some lupus medications. Severe cases can be life threatening, but most cases are mild and don't require treatment.

Lupus is an autoimmune disease that causes inflammation and damage in various tissues throughout the body, including your joints, skin, and internal organs.

Lupus can also cause issues with your blood cells, such as:

  • low red blood cell (RBC) counts and anemia
  • low white blood cell (WBC) counts and increased risk of infection
  • low platelet counts (thrombocytopenia)
  • Platelets are small blood cells responsible for helping your blood clot, such as in the case of an injury. When your platelet counts are too low, you may experience excessive bleeding.

    Learn more about the link between lupus and low platelet counts, including possible symptoms, treatment options, and what you can expect in the long term.

    Like other autoimmune diseases, lupus causes your immune system to attack cells and tissues in your body. The exact reason for this isn't known, but experts think that genetic and environmental factors may play roles in lupus development.

    The effects of lupus are systemic, meaning it affects various tissues and cells throughout the body. As your condition progresses, it may also affect your blood cells, including platelets.

    Thrombocytopenia occurs when you have lower blood platelets than what is considered typical. A typical count ranges between 150,000 and 450,000 platelets per microliter of a blood sample. The lower the count drops, the higher your risk of bleeding.

    While about 20%–40% of people with lupus develop low blood platelet counts, most of these cases aren't severe.

    When you have lupus, you may be at an increased risk of developing thrombocytopenia from your immune system attacking otherwise healthy platelets.

    Some lupus medications may also increase your risk of thrombocytopenia. These include:

    Not everyone with lupus has low platelets, though. Thrombocytopenia has other causes aside from autoimmune diseases. These include:

  • difficulties with your spleen or bone marrow
  • recent surgeries or infections
  • cancer
  • Thrombocytopenia, with or without lupus, doesn't always cause symptoms, especially in mild cases. But, when symptoms do occur, they may include:

  • easy bruising or bleeding
  • small, pinpoint-shaped red to purple spots on your skin (petechiae)
  • bruise-like spots on your skin that can range in color from red to yellow or brown (purpura)
  • frequent nosebleeds
  • bleeding gums, especially after flossing or brushing your teeth
  • bleeding that doesn't stop easily after minor injuries
  • heavy menstruation
  • blood in your urine
  • bloody stools
  • excessive fatigue
  • For some people, symptoms of low platelet counts may also be the first signs of lupus. According to a 2017 study, as many as 16% of people with lupus had thrombocytopenia months or years before receiving a lupus diagnosis.

    Doctors rely on both a physical exam and blood testing to determine if you have thrombocytopenia in lupus. They'll ask you about any bleeding-related symptoms and look for signs of easy bleeding and bruising on your skin.

    A doctor can measure your platelet count via a complete blood count (CBC). They may also order a blood smear. This involves a laboratory examination of a sample of your blood under a microscope to look for the number and size of your platelets.

    According to the Lupus Foundation of America, mild thrombocytopenia usually doesn't require treatment. But, a doctor may consider the following treatments for more severe cases:

    According to a 2017 research review, thrombocytopenia can worsen your outlook with lupus. Some studies link thrombocytopenia to a higher risk of death.

    Research also links low platelet counts to a more severe course of lupus. People with lupus and low platelets also tend to experience:

    Severely low platelet counts may increase your risk of spontaneous or severe bleeding, which may be fatal.

    But your outlook depends on the severity of both your lupus and thrombocytopenia. Treatment with immunosuppressants can often manage mild cases of lupus thrombocytopenia.

    If you or a loved one has lupus and are concerned about low platelets, consider the following pieces of information to discuss further with a doctor.

    Does a low platelet count in lupus mean I should avoid certain activities?

    Not all cases of thrombocytopenia are severe enough to warrant avoiding certain activities. In some cases, bleeding can also be spontaneous, meaning it happens without any obvious injury.

    But, if your platelet counts are extremely low, a doctor may recommend refraining from contact sports and other activities that could result in injuries. Doing so can help prevent excessive bleeding.

    What autoimmune diseases cause low platelets?

    Low blood platelets may be due to lupus and other autoimmune diseases like rheumatoid arthritis.

    Immune thrombocytopenia, aka idiopathic thrombocytopenic purpura (ITP), is another autoimmune disease in which the cause of low blood platelets may be unrelated to another condition (idiopathic).

    According to one 2022 retrospective study, ITP may be a risk factor for developing lupus.

    What would a CBC look like with lupus?

    A CBC measures all of your blood cells. With lupus, you may have lower than typical RBC, WBC, and platelet counts. A doctor may diagnose lupus thrombocytopenia if your platelet count is lower than 150,000 per microliter.

    Lupus can affect multiple systems in your body, including your blood cells. With lupus, it's possible to have low RBC, WBC, and platelet counts. You may develop thrombocytopenia if your platelets drop to lower-than-typical levels.

    For most people with lupus, low platelet counts aren't serious. You can treat the condition with some of the same medications you take for lupus. But, severe thrombocytopenia can be life threatening for some people due to excessive bleeding.

    If you're concerned about your platelet count and are experiencing symptoms of thrombocytopenia, consider talking with a doctor about possible treatments.


    Platelet-Rich Plasma Injections: What To Know

    Platelet-rich plasma (PRP) injections are a treatment used to help heal an injury. These shots, which are based on your own blood, are being used more to treat sports injuries and to help wounds heal after surgery. Some doctors use it as a cosmetic procedure to target signs of aging, such as wrinkles. 

    Plasma is the liquid part of your blood that's mostly water and protein. It lets red and white blood cells and platelets move through your bloodstream. Platelets are blood cells that make your blood clot. They also play a role in healing.

    Platelet-rich plasma injections use blood taken from your own body to treat injuries and conditions like arthritic knees and ankles. They are also used to treat hair loss. (Photo Credit: Roman Zaiets/Dreamstime)

    PRP injections are used to treat a number of conditions, including: 

    Golf and tennis elbow are among the sports injuries treated with PRP injections. 

    More recently, studies have begun looking at it as a treatment for bladder issues, problems with jaw joints, and trouble smelling after a bout of COVID-19.

    They're becoming more common for cosmetic procedures, too. For example, dermatologists and hair replacement experts use PRP injections to treat a type of hair loss called androgenic alopecia, also known as male or female pattern baldness. And some dermatologists provide PRP treatments for the face. (You may have heard these called a "vampire facial.")

    More studies are needed to see what conditions PRP might work on. So far, some research shows that it speeds healing after injury or surgery for certain conditions. Along with helping injured tissue heal, some studies show PRP injections curb pain and boost mobility for people with rotator cuff injuries and relieve symptoms in arthritic shoulders. Early research shows it might be effective in certain cases of low back pain.

    But the information to date is mixed. When researchers looked at more than 20,000 PRP injections over a period of 10 years, they found it wasn't clear whether the results justified the cost.

    A series of clinical studies in 2021 found that PRP injections worked no better than a placebo for people with osteoarthritis of the ankle or knee, or for Achilles tendinitis.

    PRP injections appear to reduce hair loss in people with male or female pattern baldness. But it's not clear whether facial PRP injections ease visible signs of aging, like wrinkles and sagging skin.

    It can take several weeks for PRP injections to start working. For some conditions, particularly those affecting the hair or the skin, it may take up to 6 months to notice the full effects. For some conditions, including hair loss, you may need to repeat the procedure to maintain the results.

    You'll probably need to stop taking certain medications that thin your blood, like aspirin and ibuprofen, before you get PRP injections. You may also need to take a break from certain vitamins or supplements, such as omega-3 fatty acids. Your doctor can tell you exactly what you need to do to prepare for these shots.

    To collect plasma, a doctor draws blood from your body and uses a machine called a centrifuge to separate the platelet-rich plasma from the rest of the blood. Then the doctor numbs the area of your body being treated with PRP injections. Once you're numb, the doctor uses a needle to inject your plasma into the area of your body being treated.

    For example, if you're being treated for a muscle injury, your doctor would inject plasma into several locations in that muscle. In some cases, doctors use ultrasound technology during the shots to make sure they're targeting the right area. PRP injections usually take about 30 minutes, though it depends on the area you're targeting.

    Once platelets are in the area that's being treated, they break down and release growth factors, which are compounds that help cells repair and renew. This is thought to trigger your body's healing process.

    Do PRP injections hurt?

    Generally, the shots are fairly painless. Your level of discomfort will depend on the location of your injury and how severe it is. The place where you get the shot might feel sore and bruise. 

    PRP doesn't usually cause major side effects. But because it involves drawing blood – if your doctor recommends it – you'll want to make sure you eat before the procedure. That will help you avoid feeling lightheaded when you get PRP injections.

    After the shot, you shouldn't wash the area that was treated for 48 hours. You might notice some soreness and bruising in the area that received injections. If you feel sharp or intense pain, let your doctor know.

    Because you're being treated with your own blood, the risk of allergic reaction is fairly low. Complications you might have include: 

  • Bleeding 
  • Damaged tissue 
  • Nerve injury 
  • Infection 
  • You can't get PRP injections if you have:

  • Abnormal platelet function or a low platelet count
  • Anemia
  • Cancer
  • An infection
  • You should only get PRP injections from a licensed doctor.

    PRP injections may or may not be covered by your health insurance, so check your plan's details. If you're getting them for cosmetic reasons – for example, PRP injections for hair loss – your insurance probably won't cover it. Treatment can cost $250 to $1,500 a session, and you may need several sessions to see results. 

    Platelet-rich plasma (PRP) injections are a treatment designed to help your body heal from injuries like tendinitis and conditions like arthritic knees and ankles. The shots are based on your own blood. The evidence on how well they work is mixed, and there's not much research on their cosmetic uses to treat wrinkles. 

    How long do platelet-rich plasma injections last? 

    The shots continue working in your body for 6 to 9 months. 

    What is the success rate for platelet-rich plasma injections?

    The success rate depends on the condition being treated. In one study, patients who had PRP injections for hair loss reported a high level of satisfaction with the treatment. But large studies that looked at PRP injections for ankle, knee, and Achilles tendon problems raised questions about how useful the shots are. 

    What is the downside of PRP injections?

    PRP injections carry a low risk of side effects. But the treatment is so new that researchers have many questions to resolve about the best formulas and techniques. The cost may not be covered by insurance, and you'll have to decide whether the possible benefits are worth the expense. 


    Signs And Symptoms Of Acute Myeloid Leukemia

    Acute myeloid leukemia symptoms may be vague and resemble other common illnesses. Symptoms can include fatigue, fever, weight loss, headaches, and more. These can occur due to low counts of red blood cells, white blood cells, and platelets.

    Acute myeloid leukemia (AML) is a type of cancer in which the bone marrow makes too many immature white blood cells called myeloblasts.

    Many AML symptoms occur due to blood cell shortage, as leukemia cells crowd out healthy blood cells and prevent their production.

    This article discusses common signs and symptoms of AML. It also looks at treatment options for AML.

    General symptoms of AML can include:

    AML cancer cells, or "blasts," are bigger than normal white blood cells, which makes it harder for them to pass through tiny blood vessels. This also prevents other blood cells from reaching tissues.

    Overcrowding the bone marrow also disrupts blood cell formation (hematopoiesis), leading to low blood cell count.

    This may cause a person with AML to experience vague, nonspecific symptoms that are common to other less serious conditions, such as the flu.

    Learn more about AML.

    Overcrowded bone marrow can result in a low white blood cell count, or neutropenia. Reduced neutrophils, a white blood cell that acts as the immune system's first line of defense, can lead to infections.

    Fever may accompany frequent infections.

    Platelets help make blood clots, which slow or stop bleeding and promote wound healing. A low platelet count, or thrombocytopenia, can lead to:

    Blasts are larger than normal white blood cells. If their count gets high, they can clog up blood vessels, making it hard for RBCs to deliver oxygen to tissues. This may cause a rare medical emergency called leukostasis.

    This is a life threatening medical emergency that causes a range of symptoms when the heart, lungs, and brain are affected. These include:

    There are various possible treatments for AML. The following factors may affect the choice of treatment:

  • AML subtype
  • history of chemotherapy use
  • presence of myelodysplastic syndrome or other blood cancer
  • presence of cancer cells in the central nervous system (CNS)
  • how AML has responded to other treatments
  • presence of systemic infection at diagnosis
  • the person's age and general health
  • Chemotherapy

    A person may require chemotherapy. Doctors may use a combination of chemotherapy drugs, such as cytarabine, and an anthracycline drug, such as daunorubicin.

    Doctors may give chemotherapy in phases to try to induce complete remission:

  • Induction therapy: This initial treatment aims to clear as many leukemia cells as possible in the blood and bone marrow and to induce remission.
  • Consolidation therapy: This begins after a person recovers from induction. It aims to kill any remaining leukemia cells. This involves giving chemotherapy in cycles followed by a period of rest in between to allow the body to recover.
  • Maintenance or post-consolidation phase: This phase involves providing a person with low doses of chemotherapy or other drugs for months to years.
  • If leukemia cells are present in the nervous system, doctors administer intrathecal chemotherapy, which involves injecting drugs directly into the spinal fluid.

    Learn more about chemotherapy and AML.

    Stem cell transplantation

    Doctors can use stem cell transplants or bone marrow transplants to give people with AML higher doses of chemotherapy. A person typically undergoes a transplant during the consolidation phase.

    Doctors may also recommend this treatment to those with relapsed or resistant AML after they undergo re-induction chemotherapy.

    Learn more about bone marrow transplant for AML.

    Targeted drugs

    Doctors may give targeted drugs along with chemotherapy. These drugs treat certain people with AML or those with specific gene mutations.

    Targeted drug therapy may also be suitable if AML does not respond to chemotherapy.

    Learn more about treatments for AML.

    Here are some frequently asked questions about AML.

    What are the first AML symptoms?

    Early signs of AML may include vague, nonspecific symptoms, such as:

    What is the first stage of acute myeloid leukemia?

    As AML does not form solid tumors and is generally widespread throughout the bloodstream and bone marrow, experts do not stage AML as with most other cancers.

    Instead, a person's outlook with AML depends on their medical status, lab test results, and the AML subtype or classification a person has.

    How do you feel when you have AML?

    AML can cause vague, nonspecific symptoms that also occur in other conditions, such as the flu. A person might have fatigue, loss of appetite, or a fever.

    How long can you have acute myeloid leukemia without knowing?

    Symptoms of AML typically develop over a number of weeks. As it is an "acute" type of leukemia, symptoms often develop rapidly.

    People with acute myeloid leukemia (AML) experience various symptoms as cancer cells crowd the bone marrow, preventing the production of normal blood cells.

    Symptoms tend to be nonspecific and can include fatigue, frequent infections, fever, headaches, and shortness of breath.

    As AML is an aggressive type of cancer, people with the condition usually need immediate treatment. The type of treatment depends on a person's overall health status and AML subtype but typically includes chemotherapy.

    A person should contact a doctor as soon as they have concerns about AML. The doctor will be able to confirm the cause of their symptoms.






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