Syndromes characteristic of diseases of the blood system. Syndromes with damage to the hematopoietic system
Anemia is a condition characterized by a decrease in the amount of hemoglobin per unit volume of blood, often with a simultaneous decrease in the number of red blood cells. Anemia is considered to be a decrease in the content of hemoglobin in the blood less than 100 g/l, erythrocytes less than 4.0×10 12 /l and serum iron less than 14.3 µmol/l. The exceptions are iron deficiency anemia and thalassemia, in which the number of red blood cells is normal.
There are different classifications of anemia:
- According to the morphology of erythrocytes, microcytic, normocytic and macrocytic anemias are distinguished. The main criterion for this subdivision is the average erythrocyte volume ( SEA):
- microcytosis - SEA less than 80 fl.,
- normocytosis - SEA - 80-95 fl.,
- macrocytosis - SEA more than 95 fl.
- Hypochromic and normochromic anemias are determined by the degree of saturation with hemoglobin. The second part of the term - "chromic" - refers to the color of red blood cells.
According to these classifications, there are:
- hypochromic microcytic anemia (small, pale red blood cells; low SEA);
- macrocytic anemia (large red blood cells; increased SEA).
- normochromic normocytic anemia (cells of normal size and appearance, normal SEA).
According to the severity of anemia are:
- mild degree (hemoglobin 91 - 119 g / l),
- moderate severity (hemoglobin 70 - 90 g / l),
- heavy (hemoglobin less than 70 g/l).
There is a pathogenetic classification of anemia:
- Anemia caused by impaired hemoglobin synthesis and iron metabolism, characterized by microcytosis and hypochromia (iron deficiency anemia, anemia in chronic diseases, sideroblastic anemia, thalassemia).
- Anemia due to impaired DNA synthesis in conditions of vitamin B12 deficiency or folic acid(macrocytic anemia).
- Normochromic normocytic anemias that do not have a common pathogenetic mechanism and subdivided depending on the reaction of the bone marrow to hypoplastic and aplastic, hemolytic and posthemorrhagic anemia.
It should be noted the existence of conditions that are characterized by signs of anemia, but are not accompanied by a decrease in hemoglobin or erythrocytes, but are manifested by a violation of the ratio between the number of erythrocytes and plasma volume (pregnancy hydremia, overhydration in heart failure, CRF) and a decrease in plasma volume (dehydration, peritoneal dialysis, diabetic acidosis).
In anemia, hypoxia of organs and tissues with the possible subsequent development of dystrophic processes has the main pathogenetic significance. There are compensatory mechanisms aimed at reducing and eliminating the consequences of hypoxia. These include hyperfunction of the cardiovascular system, due to the action of underoxidized products on the centers of regulation of the cardiovascular system. In patients, the heart rate and minute volume increase, the total peripheral resistance increases.
Also to compensatory mechanisms include: an increase in the physiological activity of erythrocytes, a shift in the dissociation curve of oxyhemoglobin and an increase in the permeability of the vascular wall for blood gases. It is also possible to increase the content and activity of iron-containing enzymes (cytochrome oxidase, peroxidase, catalase), which are potential oxygen carriers.
The clinic of anemic syndrome is characterized by general anemic complaints of general weakness, dizziness, tendency to faint, palpitations, shortness of breath, especially when physical activity stabbing pains in the region of the heart. With a decrease in hemoglobin less than 50 g / l, signs of severe heart failure appear.
During examination, pallor is detected skin, tachycardia, a slight increase in the left border of relative cardiac dullness, systolic murmur at the top, "the noise of the top" on the jugular veins. An ECG can reveal signs of left ventricular hypertrophy, a decrease in the height of the T wave.
sideropenic syndrome
This syndrome is characterized by a decrease in the iron content in the blood, which leads to a decrease in the synthesis of hemoglobin and its concentration in erythrocytes, as well as a decrease in the activity of iron-containing enzymes, especially α-glycerophosphate dehydrogenase.
Clinically, the syndrome is manifested by a change in taste, an addiction to eating chalk, toothpaste, clay, raw cereals, raw coffee, unpeeled sunflower seeds, starched linen (amylophagia), ice (pagophagia) and smells of clay, lime, gasoline, acetone, printing ink .
Dryness and atrophy of the skin, fragility of nails and hair, hair loss are noted. The nails are flattened, sometimes have a concave (spoon-shaped) shape (koilonychia). The phenomena of angular stomatitis, atrophy of the papillae of the tongue and its redness develop, swallowing is disturbed (sideropenic dysphagia, Plummer-Vinson syndrome).
At laboratory research reveal a decrease in serum iron (less than 12 µmol/l), an increase in total iron-binding capacity (more than 85 µmol/l), a decrease in the content of ferritin in the blood. The number of sideroblasts in the bone marrow decreases.
Hemorrhagic syndrome
hemorrhagic syndrome - pathological condition, characterized by a tendency to internal and external bleeding and the appearance of various sizes of hemorrhages. The reasons for the development of hemorrhagic syndrome are changes in the platelet, plasma and vascular components of hemostasis. Accordingly, there are three groups of diseases manifested by hemorrhagic syndrome.
The first group of diseases
The first group includes diseases in which the number and functional properties of platelets are changed (thrombocytopenia, thrombocytopathy). The clinic of this group of diseases is characterized by the appearance on the skin and mucous membranes of "bruises" of various sizes and small punctate hemorrhages (petechiae). Also characteristic is the development of spontaneous bleeding - nasal, gingival, gastrointestinal, uterine, hematuria. The intensity of bleeding and the amount of blood lost are usually insignificant. This type of bleeding is typical, for example, for Werlhof's disease (thrombocytopenic purpura) and is accompanied by an increase in the duration of bleeding, impaired retraction blood clot, a decrease in the retention index (adhesiveness) and platelet count. Symptoms of tourniquet and pinch and cuff test are positive.
The second group of diseases
The second group includes diseases in which bleeding is caused by hereditary or acquired deficiency of procoagulants or high content anticoagulants leading to clotting disorders (hemophilia, hypo- and afibrinogenemia, dysprothrombinemia). Patients develop massive hemorrhages in soft tissues and joints (hemarthrosis). There are no petechiae. Prolonged nosebleeds, bleeding from the gums after extraction of teeth and bleeding after open injuries of the skin and soft tissues are possible. Laboratory signs- prolongation of blood clotting time, changes in autocoagulation test parameters.
The third group of diseases
The third group consists of diseases in which vascular permeability is changed (Randu-Osler hereditary telangiectasia, Shenlein-Genoch hemorrhagic vasculitis). Rendu-Osler disease is characterized by telangiectasias on the lips and mucous membranes and may present with hemoptysis, intestinal bleeding, hematuria. With Shenlein-Genoch disease, small dotted hemorrhagic rash on inflammatory background. The rash rises slightly above the surface of the skin and gives light feeling volume on palpation. There may be hematuria. Standard coagulation tests have not been changed.
hemolytic syndrome
The syndrome includes diseases that are characterized by a decrease in the number of erythrocytes and the concentration of hemoglobin in the blood due to increased hemolysis of erythrocytes.
Increased destruction of red blood cells is due to the following factors:
- changes in the metabolism and structure of membranes, erythrocyte stroma and hemoglobin molecules;
- damaging effect of chemical, physical and biological factors of hemolysis on the erythrocyte membrane;
- slowing down the movement of erythrocytes in the intersinus spaces of the spleen, which contributes to their destruction by macrophages;
- increased phagocytic activity of macrophages.
Indicators of hemolysis are:
- an increase in the formation of free bilirubin and a corresponding change in pigment metabolism;
- change in osmotic resistance of erythrocytes;
- reticulocytosis.
TO blood system include hematopoietic organs (bone marrow, lymph nodes, spleen, liver) and blood itself with formed elements, plasma and chemicals.
The main hematopoietic organ is the red bone marrow, in which the ancestral nuclear stem cells are formed - blasts . Formed elements are sequentially formed from blasts, mature and are released into the peripheral blood: erythrocytes, leukocytes and platelets. Erythrocytes are produced mainly in the red bone marrow, leukocytes - in the spleen and lymph nodes (one of the forms of leukocytes is produced in the spleen - monocytes, in the lymph nodes - lymphocytes), platelets - in the red bone marrow.
Blood supplies nutrients to all tissues of the body and removes harmful products. blood plasma - clear liquid that remains after removal shaped elements from blood. Plasma consists of water with protein substances dissolved in it, sugar, the smallest particles of fat, and various salts. The amount of blood in the human body is 5-5.5 liters.
Formed elements of blood:
Erythrocytes. Norm: for men: 4.0 - 5.5 x 10 12 / l. For women: 3.7 - 4.7 x 10 12 / l.
Red blood cells are evaluated in a smear. Pay attention to their size, shape, color and cellular inclusions. Normal erythrocytes have round shape. With anemia different nature the size of erythrocytes changes. The appearance of red blood cells of different sizes is called anisocytosis. The predominance of small erythrocytes - microcytosis- characteristic of iron deficiency anemia, macrocytosis- with B 12 deficiency anemia. Under pathological conditions of maturation of erythrocytes, a change in the shape of erythrocytes is noted - poikilocytosis. Increase in the number of red blood cells (erythrocytosis) can be absolute or relative. The cause of absolute erythrocytosis is a reactive irritation of erythropoiesis with an increase in the mass of circulating erythrocytes in congenital and acquired heart defects, pneumosclerosis, some tumors: kidney cancer, pituitary adenoma, and relative erythrocytosis is blood clotting without an increase in erythropoiesis during shock, burns, a rapid increase in edema, diarrhea, profuse vomiting. At erythremia the number of erythrocytes increases and reaches 9.0 - 12.0 x 10 12 /l.
Reducing the number of red blood cells - erythrocytopenia. It may be the result of increased breakdown of red blood cells in hemolytic anemia, vitamin B12 deficiency, iron, bleeding, insufficient protein content in food, leukemia, multiple myeloma, metastases of malignant tumors, etc.
Red blood cells give blood a red color, as they contain a special substance - hemoglobin. The norm for men: 130 - 160 g / l, for women: 120 - 140 g / l.
Increase in hemoglobin observed with thickening of the blood after vomiting, with burns, severe diarrhea, various intoxications, erythremia, some congenital heart defects. Decrease in hemoglobin noted with iron deficiency and hemolytic anemia, after blood loss, with a deficiency of vitamin B12 and folic acid. Erythrocytes, passing through the lungs with blood, capture the oxygen of the air and carry it to all organs and tissues.
The lifespan of an erythrocyte is 120 days; they are destroyed most of all in the spleen. The hemoglobin released after the destruction of red blood cells is integral part bilirubin formed by the liver, iron is used to build new red blood cells.
Availability reticulocytes(immature forms of erythrocytes, the norm is up to 1% in the blood) in peripheral blood and in the bone marrow (true reticulocytosis) is an indicator of the regenerative capacity of the bone marrow. An increase in them is noted with hemolytic anemia, blood loss, malaria, polycythemia, and during the treatment of iron deficiency and B 12 deficiency anemia.
Leukocytes. Leukocytes are capable of active movement, they can absorb substances foreign to the body, such as dead cells (phagocytosis). They are playing important role in protecting the body from microbes.
Leukocytes, unlike erythrocytes, contain a cell nucleus. The blood normally contains 4-9 10 9 /l of leukocytes. There are granulocytes (granular - with granular protoplasm) and agranulocytes (non-granular) leukocytes. Granulocytes are eosinophils, basophils, neutrophils. Agranulocytes are lymphocytes and monocytes.
Towards total number of leukocytes, neutrophilic granulocytes make up about 50-70%, of which myelocytes are not normally detected in peripheral blood, young up to 1%, stab up to 5%, segmented 51-67%; lymphocytes - up to 30%, monocytes - up to 8%, eosinophils - 2-4%, basophils - 0.5-1%.
An increase in the number of leukocytes ( leukocytosis) is noted in acute inflammatory and purulent processes, poisoning and acute infectious diseases, with the exception of most viral infections, with closed skull injuries, cerebral hemorrhages, diabetic and uremic coma, in the first days after myocardial infarction, in the primary reaction of acute radiation sickness. Leukocytosis in acute and chronic leukemia reaches hundreds of thousands -100.0 x 10 9 /l and more.
Decrease in the number of leukocytes ( leukopenia) is observed with radiation sickness during the peak period, viral diseases (Botkin's disease, influenza, measles), systemic lupus erythematosus, hypo- and aplastic anemia, aleukemic variants of acute leukemia, after taking various drugs (sulfonamides).
Eosinophilia(increase in the content of eosinophils) is often observed in helminthiases, with allergic diseases (bronchial asthma, dermatoses, etc.); with collagenoses (rheumatism, etc.); with burns and frostbite. eosinopenia(decrease in the content of eosinophils) occurs when typhoid fever, viral hepatitis and other infectious and viral diseases.
Shift leukocyte formula to the left - this is an increase in the number of stab, young and the appearance of myelocytes, occurs with tonsillitis, acute appendicitis, lung abscess, active tuberculosis, severe forms pneumonia, diphtheria, sepsis, purulent meningitis, acute cholecystitis, peritonitis, with leukemia and leukemoid reactions. With leukemia and leukemoid reactions, there may be myelocytes, promyelocytes and myeloblasts in the peripheral blood.
lymphocytosis points to favorable course pneumonia disease, erysipelas, diphtheria, tuberculosis and other chronic infections. Lymphopenia observed in lymphogranulomatosis.
Monocytosis observed in diphtheria, rubella, scarlet fever.
Basophilia noted in diabetes mellitus, acute hepatitis with jaundice, in radiologists exposed to long-term exposure to low doses; with hypothyroidism, lymphogranulomatosis, chronic myeloid leukemia. The number of basophils decreases with tuberculosis, hyperthyroidism, after X-ray therapy, with acute leukemia.
platelets (platelets) are involved in the process of blood clotting. Normally, they contain 180-320 10 9 /l. An increase in the number of platelets - thrombocytosis observed in posthemorrhagic anemia, erythremia, chronic myeloid leukemia, malignant tumors, spleen atrophy of various etiologies, after removal of the spleen. Thrombocytopenia characteristic of idiopathic thrombocytopenic purpura (Werlhof's disease), radiation sickness, hypo- or aplastic anemia, acute leukemia, hypersplenism, lead poisoning, benzene, chronic nephritis.
ESR. Norm: For women: 2-15 mm / h. For men: 2-10 mm/h.
ESR is not a specific indicator for any disease, but the acceleration of ESR indicates the presence of a pathological process. It rises 24 hours or a few days after the onset with any inflammatory process and infectious disease (with purulent-septic processes, parenchymal liver lesions, collagenoses, including rheumatism), as well as with anemia, after myocardial infarction, blood transfusion. After the disappearance clinical signs ESR is slowly returning to normal.
Diagnosis of diseases of the blood system.
Complaints hematological patients are very diverse and correspond to clinical syndromes :
- anemic syndrome : persistent headaches, dizziness, tinnitus, shortness of breath, a feeling of "lack of air", palpitations, pain in the heart, fainting, fatigue and irritability, weakening of memory, "flies before the eyes", objectively manifested by pallor of the skin and mucous membranes, one can detect increased respiration and heart rate, systolic murmur over all points of auscultation of the heart and a "top" noise over large veins (due to the acceleration of blood circulation and a decrease in blood viscosity due to erythrocytopenia), a moderate decrease blood pressure, pastosity lower extremities. Complaints are associated with cell hypoxia and impaired tissue metabolism, manifested in anemia, leukemia, blood loss. Trophic changes in the skin (thinning, dryness, hair loss, brittle nails) are associated with a lack of iron-containing enzymes in the body.
- hemorrhagic syndrome: hemorrhagic manifestations on the skin: hemorrhages in the skin, muscles, joints, at the injection site, petechial rash, bruising of all sizes and stages; bleeding (nasal, gingival, uterine, intestinal). Their causes: thrombocytopenia, platelet deficiency, increased permeability of the vascular wall, intravascular coagulation.
- ulcerative necrotic syndrome: sore throat, swallowing disorder, salivation, bloating, cramping abdominal pain, mushy stool, mucosal lesions aphthous stomatitis and necrotizing tonsillitis, esophagitis). Symptoms are due to sharp decline or the complete disappearance of granulocytes from the blood, as well as with leukemic growth in the mucous membranes.
- lymphadenopathy: swollen lymph nodes and changes in the configuration of the neck, inguinal, axillary zone. Persistent dry cough and shortness of breath during exercise can be observed with an increase in mediastinal lymph nodes; feeling of fullness in the abdomen, bloating, flatulence and unstable chair, the phenomenon of intestinal obstruction - with an increase in mesenteric and retroperitoneal lymph nodes. In diseases of the blood system, the lymph nodes are often dense, painless, they slowly but steadily increase in size. For lymphadenopathy of inflammatory origin, the soreness of enlarged nodes, the formation of fistulas, the phenomena of general intoxication (fever, chills, neutrophilic leukocytosis, etc.), the disappearance of signs of lymphadenitis as the inflammatory process subsides are characteristic. Significant splenomegaly and hepatomegaly lead to visible enlargement of the abdomen, which is characteristic of some variants of chronic leukemia ( chronic myeloid leukemia, lymphocytic leukemia, etc.) An increase in the liver in hematological patients occurs most often due to its acute dystrophy or toxic-allergic hepatitis with acute leukemia, proliferation of leukemic tissue in them in chronic leukemia. Enlargement of the spleen in hematological patients is the result of intense hemorrhage (for example, with hemolytic anemia), tumor growth in it (for example, with leukemia, lymphogranulomatosis, etc.).
- intoxication syndrome: weakness (observed in almost all patients in the advanced stage of leukemia due to tissue hypoxia and intoxication of the body with leukemic cells). Sweating (and more often expressed in daytime, which distinguishes it from chronic inflammatory diseases), dyspnea on exertion, palpitations, anorexia, weight loss up to cachexia. Skin itching initially occurs after taking a bath, but later becomes painful and constant - caused by the breakdown of cells in the capillaries of the skin with impaired microcirculation, thrombosis and the release of histamine-like substances, sometimes combined with pain in the tips of the fingers and toes. Persistent fever: combined with sweating and due to pyrogenic action products of mass decay of erythrocytes, leukocytes, and other blood cells.
- osteoarthropathic syndrome: pain in the bones (ossalgia) and joints (arthralgia), their swelling, hyperemia of the skin over them, dysfunction of the joint (arthropathy). Arthralgia is sometimes the only symptom, so the bone marrow should be examined. Ossalgia occurs in the vertebrae, ribs, sternum, ilium, less often in the tubular and bones of the skull. They are well identified with pressure on the bone or light tapping on it.
- immunodeficiency syndrome: frequent colds, infectious complications(pneumonia, bronchitis, pyelonephritis, pyoderma) - arise due to the defectiveness of the immune system, when antibodies are produced against normal body cells.
Disease history. Finding out the question of how the patient fell ill, it is necessary to ask in detail about the general condition of the patient that preceded the disease, as well as the alleged factors that provoked the disease. It is necessary to study the dynamics of each symptom, whether there was a blood test, and what were its results; find out what was treated and with what effect.
Anamnesis of life:
It is important to clarify the permanent place of residence, since the unfavorable ecological situation is a risk factor for hematological diseases.
It is necessary to find out the factors that are important in the etiology of the disease: improper, one-sided nutrition, insufficient exposure to fresh air, acute and chronic intoxication in the production of mercury salts, lead compounds, phosphorus, etc.; radiation injury; information about previous diseases that can be complicated by blood diseases - stomach and duodenal ulcers (anemia), diseases with hemorrhagic syndrome, kidney failure.
The question of heredity is of great importance in the diagnosis of hemophilia, hereditary anemia.
Taking medications (levomycetin, amidopyrine, cytostatics). To rule out drug damage, ask for a list of all medications the patient has taken in the last 3-4 weeks.
Methods of objective examination of patients:
inspection data:
Pale skin with different shade(chlorosis or a greenish tint - with iron deficiency, jaundice - with hemolytic anemia). With erythremia - "full-blooded", cherry-red color of the skin of the face, neck, hands. Examining the skin, one can detect hemorrhages in the form of spots of various sizes and shapes - from small punctate (petechiae) to larger ones (purpura, ecchymosis); the largest hemorrhages are called bruises. You should pay attention to the state of trophism of the skin. With iron deficiency anemia, the skin is dry, flaky, the hair is brittle, split.
Examination of the oral cavity confirms ulcerative necrotic syndrome, leukemic infiltration (swelling of the gums, enlargement of the tonsils).
An increase in the abdomen occurs with hepato- and splenomegaly (enlargement of the liver and spleen).
Decrease in body weight, scratching on the skin, fever confirm the intoxication of the body.
Deformation and increase in the size of the joints with hemorrhage (hemophilia). Swelling and limitation of movement in the joints are often asymmetrical. Sometimes with blood diseases, fingers in the form of "drumsticks" with nails in the form of "watch glasses" are observed.
Increased respiration and pulse rate, systolic noise over all auscultation points, lowering blood pressure, pastosity of the lower extremities, "top noise" over large veins due to accelerated blood circulation and reduced blood viscosity.
Palpation. If leukemia is suspected, the skeletal system is carefully examined: pressure on flat bones or epiphyses of tubular bones, tapping on them is painful.
Valuable information is provided by palpation of the lymph nodes and spleen. With lymphocytic leukemia and lymphogranulomatosis, systemicity, multiplicity of lesions of the lymph nodes are characteristic - if one group is affected, then the defeat of other groups is added. Normally, the spleen is not palpable. It becomes accessible to palpation with a significant increase (splenomegaly).
Research of a hemorrhagic syndrome. The permeability of capillaries is checked by a symptom of a tourniquet, a pinch, a jar test (the appearance of petechiae is normally observed after 3 minutes distal to the tourniquet).
Percussion. Used to define the boundaries of the spleen.
Auscultation. With anemia, a systolic murmur is heard over the heart and blood vessels, which is associated with a decrease in blood viscosity and an increase in the speed of blood movement in the vessels.
Laboratory research methods.
Blood diseases are an extensive collection of pathologies that are very heterogeneous in terms of causes, clinical manifestations and course, combined into one general group by the presence of violations of the number, structure or functions cellular elements(erythrocytes, platelets, leukocytes) or blood plasma. Chapter medical science dealing with diseases of the blood system is called hematology.
Blood diseases and diseases of the blood system
The essence of blood diseases is to change the number, structure or functions of erythrocytes, platelets or leukocytes, as well as violations of plasma properties in gammopathy. That is, a blood disease may consist in an increase or decrease in the number of red blood cells, platelets or white blood cells, as well as in a change in their properties or structure. In addition, pathology may consist in changing the properties of plasma due to the appearance of pathological proteins in it or a decrease / increase in the normal amount of components of the liquid part of the blood.Typical examples of blood diseases caused by a change in the number of cellular elements are, for example, anemia or erythremia (increased number of red blood cells in the blood). And an example of a blood disease caused by a change in the structure and functions of cellular elements is sickle cell anemia, lazy leukocyte syndrome, etc. Pathologies in which the quantity, structure, and functions of cellular elements change are hemoblastoses, which are commonly called blood cancer. characteristic disease blood, due to a change in the properties of the plasma - this is multiple myeloma.
Diseases of the blood system and diseases of the blood are different variants names of the same set of pathologies. However, the term "diseases of the blood system" is more accurate and correct, since the entire set of pathologies included in this group concerns not only the blood itself, but also hematopoietic organs such as bone marrow, spleen, and lymph nodes. After all, a blood disease is not just a change in the quality, quantity, structure and functions of cellular elements or plasma, but also certain disorders in the organs responsible for the production of cells or proteins, as well as for their destruction. Therefore, in fact, in any blood disease, a change in its parameters is caused by a malfunction of any organ directly involved in the synthesis, maintenance and destruction of blood elements and proteins.
Blood is a very labile tissue of the body in terms of its parameters, since it reacts to various factors environment, and also because it is in it that wide range biochemical, immunological and metabolic processes. Due to such a relatively "wide" spectrum of sensitivity, blood parameters can change under various conditions and diseases, which does not indicate the pathology of the blood itself, but only reflects the reaction taking place in it. After recovery from the disease, blood parameters return to normal.
But blood diseases are a pathology of its immediate components, such as red blood cells, white blood cells, platelets or plasma. This means that in order to bring blood parameters back to normal, it is necessary to cure or neutralize the existing pathology, bringing the properties and number of cells (erythrocytes, platelets and leukocytes) as close as possible to normal values. However, since the change in blood parameters can be the same both in somatic, neurological and mental diseases, and in blood pathologies, it takes some time and additional examinations to identify the latter.
Blood diseases - list
Currently, doctors and scientists distinguish the following blood diseases that are included in the list of the International Classification of Diseases of the 10th revision (ICD-10):1. Iron-deficiency anemia;
2. B12 deficiency anemia;
3. folate deficiency anemia;
4. Anemia due to protein deficiency;
5. Anemia from scurvy;
6. Unspecified anemia due to malnutrition;
7. Anemia due to enzyme deficiency;
8. Thalassemia (alpha thalassemia, beta thalassemia, delta beta thalassemia);
9. Hereditary persistence of fetal hemoglobin;
10. sickle cell anemia;
11. Hereditary spherocytosis (Minkowski-Choffard anemia);
12. Hereditary elliptocytosis;
13. Autoimmune hemolytic anemia;
14. Medical non-autoimmune hemolytic anemia;
15. Hemolytic-uremic syndrome;
16. Paroxysmal nocturnal hemoglobinuria (Marchiafava-Micheli disease);
17. Acquired pure red cell aplasia (erythroblastopenia);
18. Constitutional or drug-induced aplastic anemia;
19. Idiopathic aplastic anemia;
20. Acute posthemorrhagic anemia(after acute blood loss);
21. Anemia in neoplasms;
22. Anemia in chronic somatic diseases;
23. Sideroblastic anemia (hereditary or secondary);
24. Congenital dyserythropoietic anemia;
25. Acute myeloblastic undifferentiated leukemia;
26. Acute myeloid leukemia without maturation;
27. Acute myeloid leukemia with maturation;
28. Acute promyelocytic leukemia;
29. Acute myelomonoblastic leukemia;
30. Acute monoblastic leukemia;
31. Acute erythroblastic leukemia;
32. Acute megakaryoblastic leukemia;
33. Acute lymphoblastic T-cell leukemia;
34. Acute lymphoblastic B-cell leukemia;
35. Acute panmyeloid leukemia;
36. Letterer-Siwe disease;
37. myelodysplastic syndrome;
38. Chronic myeloid leukemia;
39. Chronic erythromyelosis;
40. Chronic monocytic leukemia;
41. Chronic megakaryocytic leukemia;
42. Subleukemic myelosis;
43. mast cell leukemia;
44. macrophage leukemia;
45. Chronic lymphocytic leukemia;
46. hairy cell leukemia;
47. Polycythemia vera (erythremia, Wakez's disease);
48. Cesari's disease (lymphocytoma of the skin);
49. Fungal mycosis;
50. Burkitt's lymphosarcoma;
51. Lennert's lymphoma;
52. Histiocytosis is malignant;
53. Malignant mast cell tumor;
54. True histiocytic lymphoma;
55. MALT-lymphoma;
56. Hodgkin's disease (lymphogranulomatosis);
57. non-Hodgkin's lymphomas;
58. multiple myeloma(generalized plasmacytoma);
59. Macroglobulinemia Waldenström;
60. Heavy alpha chain disease;
61. gamma heavy chain disease;
62. Disseminated intravascular coagulation (DIC);
63.
64. Deficiency of K-vitamin-dependent blood clotting factors;
65. Coagulation factor I deficiency and dysfibrinogenemia;
66. Coagulation factor II deficiency;
67. Coagulation factor V deficiency;
68. deficit VII factor blood clotting (hereditary hypoproconvertinemia);
69. hereditary deficiency Factor VIII blood clotting (von Willebrand's disease);
70. Hereditary deficiency of IX blood coagulation factor (Christamas disease, hemophilia B);
71. Hereditary deficiency of X factor of blood clotting (Stuart-Prauer disease);
72. Hereditary deficiency of XI blood coagulation factor (hemophilia C);
73. Coagulation factor XII deficiency (Hageman defect);
74. Coagulation factor XIII deficiency;
75. Deficiency of plasma components of the kallikrein-kinin system;
76. Antithrombin III deficiency;
77. Hereditary hemorrhagic telangiectasia (Rendu-Osler disease);
78. Thrombasthenia Glanzmann;
79. Bernard-Soulier syndrome;
80. Wiskott-Aldrich syndrome;
81. Chediak-Higashi syndrome;
82. TAR syndrome;
83. Hegglin's syndrome;
84. Kazabakh-Merritt syndrome;
85.
86. Ehlers-Danlos syndrome;
87. Gasser's syndrome;
88. allergic purpura;
89.
90. Simulated bleeding (Munchausen's syndrome);
91. Agranulocytosis;
92. Functional disorders of polymorphonuclear neutrophils;
93.
eosinophilia;
94.
Methemoglobinemia;
95.
Familial erythrocytosis;
96.
Essential thrombocytosis;
97.
Hemophagocytic lymphohistiocytosis;
98.
Hemophagocytic syndrome due to infection;
99.
cytostatic disease.
The above list of diseases includes most of the currently known blood pathologies. However, some rare diseases or forms of the same pathology are not included in the list.
Blood disease - types
The whole set of blood diseases can be conditionally divided into the following large groups, depending on which type of cellular elements or plasma proteins turned out to be pathologically altered:1. Anemia (conditions in which hemoglobin levels are below normal);
2. Hemorrhagic diathesis or pathology of the hemostasis system (blood clotting disorders);
3. Hemoblastoses (various neoplastic diseases their blood cells, bone marrow or lymph nodes);
4. Other blood diseases (diseases that do not belong to either hemorrhagic diathesis, or anemia, or hemoblastoses).
This classification is very general, dividing all blood diseases into groups based on which general pathological process is the leading one and which cells have been affected by the changes. Of course, in each group there is a very wide range specific diseases, which, in turn, are also subdivided into species and types. Consider the classification of each specified group of blood diseases separately, so as not to create confusion due to the large amount of information.
anemia
So, anemia is a combination of all conditions in which there is a decrease in hemoglobin levels below normal. Currently, anemias are classified into the following types, depending on the leading general pathological cause of their occurrence:1. Anemia due to impaired synthesis of hemoglobin or red blood cells;
2. Hemolytic anemia associated with increased breakdown of hemoglobin or red blood cells;
3. Hemorrhagic anemia associated with blood loss.
Anemia due to blood loss are divided into two types:
- Acute posthemorrhagic anemia - occurs after a rapid simultaneous loss of more than 400 ml of blood;
- Chronic posthemorrhagic anemia - occurs as a result of prolonged, constant blood loss due to small but constant bleeding (for example, with heavy menstruation, with bleeding from a stomach ulcer, etc.).
1. Aplastic anemias:
- Red cell aplasia (constitutional, medical, etc.);
- Partial red cell aplasia;
- Anemia Blackfan-Diamond;
- Anemia Fanconi.
3. myelodysplastic syndrome.
4. Deficiency anemia:
- Iron-deficiency anemia;
- folate deficiency anemia;
- B12 deficiency anemia;
- Anemia on the background of scurvy;
- Anemia due to lack of protein in the diet (kwashiorkor);
- Anemia with a lack of amino acids (orotaciduric anemia);
- Anemia with a lack of copper, zinc and molybdenum.
- Porphyria - sideroachristic anemia (Kelly-Paterson syndrome, Plummer-Vinson syndrome).
7. Anemia with increased consumption of hemoglobin and other substances:
- Anemia of pregnancy;
- Anemia of breastfeeding;
- Anemia of athletes, etc.
Hemolytic anemia due to increased breakdown of red blood cells are divided into hereditary and acquired. Accordingly, hereditary hemolytic anemias are caused by any genetic defects transmitted by parents to offspring, and therefore are incurable. And acquired hemolytic anemias are associated with the influence of environmental factors, and therefore are completely curable.
Lymphomas are currently divided into two main varieties - Hodgkin's (lymphogranulomatosis) and non-Hodgkin's. Lymphogranulomatosis (Hodgkin's disease, Hodgkin's lymphoma) is not divided into types, but can occur in various clinical forms, each of which has its own clinical features and associated nuances of therapy.
Non-Hodgkin's lymphomas are divided into the following types:
1.
Follicular lymphoma:
- Mixed large and small cell with split nuclei;
- Large cell.
- Small cell;
- Small cell with split nuclei;
- Mixed small cell and large cell;
- reticulosarcoma;
- immunoblastic;
- Lymphoblastic;
- Burkitt's tumor.
- Cesari disease;
- Mycosis fungoides;
- Lennert's lymphoma;
- Peripheral T-cell lymphoma.
- Lymphosarcoma;
- B-cell lymphoma;
- MALT-lymphoma.
Hemorrhagic diathesis (diseases of blood clotting)
Hemorrhagic diathesis (blood clotting diseases) is a very extensive and variable group of diseases, which are characterized by one or another violation of blood clotting, and, accordingly, a tendency to bleeding. Depending on which cells or processes of the blood coagulation system are disturbed, all hemorrhagic diatheses are divided into the following types: 1. Syndrome of disseminated intravascular coagulation (DIC).
2. Thrombocytopenia (the number of platelets in the blood is below normal):
- Idiopathic thrombocytopenic purpura (Werlhof's disease);
- Alloimmune purpura of newborns;
- Transimmune purpura of newborns;
- Heteroimmune thrombocytopenia;
- allergic vasculitis;
- Evans syndrome;
- Vascular pseudohemophilia.
- Hermansky-Pudlak disease;
- TAR syndrome;
- May-Hegglin syndrome;
- Wiskott-Aldrich disease;
- Thrombasthenia Glanzmann;
- Bernard-Soulier syndrome;
- Chediak-Higashi syndrome;
- Willebrand disease.
- Rendu-Osler-Weber disease;
- Louis-Bar syndrome (ataxia-telangiectasia);
- Kazabah-Merritt syndrome;
- Ehlers-Danlos syndrome;
- Gasser's syndrome;
- Hemorrhagic vasculitis (Scheinlein-Genoch disease);
- Thrombotic thrombocytopenic purpura.
- Fletcher defect;
- Williams defect;
- Fitzgerald defect;
- Flajac defect.
- Afibrinogenemia;
- Consumption coagulopathy;
- fibrinolytic bleeding;
- fibrinolytic purpura;
- Lightning purpura;
- Hemorrhagic disease of the newborn;
- Deficiency of K-vitamin-dependent factors;
- Coagulation disorders after taking anticoagulants and fibrinolytics.
- fibrinogen deficiency;
- Deficiency of coagulation factor II (prothrombin);
- Coagulation factor V deficiency (labile);
- Coagulation factor VII deficiency;
- Coagulation factor VIII deficiency (hemophilia A);
- Coagulation factor IX deficiency (Christmas disease, hemophilia B);
- Coagulation factor X deficiency (Stuart-Prower);
- Factor XI deficiency (hemophilia C);
- Coagulation factor XII deficiency (Hageman's disease);
- Deficiency of coagulation factor XIII (fibrin-stabilizing);
- Thromboplastin precursor deficiency;
- Deficiency of AS-globulin;
- Proaccelerin deficiency;
- Vascular hemophilia;
- Dysfibrinogenemia (congenital);
- Hypoproconvertinemia;
- Ovren's disease;
- Increased content of antithrombin;
- Increased content of anti-VIIIa, anti-IXa, anti-Xa, anti-XIa (anti-clotting factors).
Other blood diseases
This group includes diseases that for some reason cannot be attributed to hemorrhagic diathesis, hemoblastosis and anemia. Today, this group of blood diseases includes the following pathologies:1. Agranulocytosis (absence of neutrophils, basophils and eosinophils in the blood);
2. Functional disturbances in the activity of stab neutrophils;
3. Eosinophilia (an increase in the number of eosinophils in the blood);
4. Methemoglobinemia;
5. Familial erythrocytosis (an increase in the number of red blood cells);
6. Essential thrombocytosis (an increase in the number of blood platelets);
7. Secondary polycythemia (an increase in the number of all blood cells);
8. Leukopenia (decreased number of white blood cells in the blood);
9. Cytostatic disease (a disease associated with the use of cytotoxic drugs).
Blood diseases - symptoms
Symptoms of blood diseases are very variable, because they depend on which cells are involved in the pathological process. So, with anemia, the symptoms of a lack of oxygen in the tissues come to the fore, with hemorrhagic vasculitis- increased bleeding, etc. Thus, there are no single and common symptoms for all blood diseases, since each specific pathology is characterized by a certain unique combination only its inherent clinical signs. However, it is possible to conditionally distinguish the symptoms of blood diseases inherent in all pathologies and caused by impaired blood functions. So, common to various diseases blood can be considered the following symptoms:
- Weakness;
- Dyspnea;
- palpitations;
- Decreased appetite;
- Elevated body temperature, which keeps almost constantly;
- Frequent and long-term infectious and inflammatory processes;
- itchy skin;
- Perversion of taste and smell (a person begins to like specific smells and tastes);
- Pain in the bones (with leukemia);
- Bleeding by the type of petechiae, bruising, etc.;
- Constant bleeding from the mucous membranes of the nose, mouth and organs of the gastrointestinal tract;
- Pain in the left or right hypochondrium;
- Low performance.
Blood disease syndromes
A syndrome is a stable set of symptoms characteristic of a disease or group of pathologies that have a similar pathogenesis. Thus, blood disease syndromes are groups of clinical symptoms united by a common mechanism of their development. Moreover, each syndrome is characterized by a stable combination of symptoms that must be present in a person in order to identify any syndrome. With blood diseases, several syndromes are distinguished that develop with various pathologies.So, at present, doctors distinguish the following syndromes of blood diseases:
- anemic syndrome;
- hemorrhagic syndrome;
- Ulcerative necrotic syndrome;
- intoxication syndrome;
- ossalgic syndrome;
- Protein pathology syndrome;
- sideropenic syndrome;
- Plethoric syndrome;
- icteric syndrome;
- Lymphadenopathy syndrome;
- Hepato-splenomegaly syndrome;
- Blood loss syndrome;
- feverish syndrome;
- Hematological syndrome;
- Bone marrow syndrome;
- enteropathy syndrome;
- Arthropathy Syndrome.
Anemia syndrome
Anemia syndrome is characterized by a set of symptoms provoked by anemia, that is, a low content of hemoglobin in the blood, due to which the tissues experience oxygen starvation. Anemia syndrome develops in all blood diseases, however, in some pathologies, it appears on initial stages, and for others - at later times. So, the manifestations of an anemic syndrome are the following symptoms:
- Paleness of the skin and mucous membranes;
- Dry and flaky or moist skin;
- Dry, brittle hair and nails;
- Bleeding from mucous membranes - gums, stomach, intestines, etc .;
- Dizziness;
- Shaky gait;
- Darkening in the eyes;
- Noise in ears;
- Fatigue;
- Drowsiness;
- Shortness of breath when walking;
- Palpitation.
Hemorrhagic syndrome
Hemorrhagic syndrome is manifested by the following symptoms:- Bleeding gums and prolonged bleeding during tooth extraction and injury to the oral mucosa;
- Feeling of discomfort in the stomach;
- red blood cells or blood in the urine;
- Bleeding from punctures from injections;
- Bruises and petechial hemorrhages on the skin;
- Headache;
- Soreness and swelling of the joints;
- The impossibility of active movements due to pain caused by hemorrhages in the muscles and joints.
1. thrombocytopenic purpura;
2. von Willebrand disease;
3. Rendu-Osler disease;
4. Glanzmann's disease;
5. Hemophilia A, B and C;
6. Hemorrhagic vasculitis;
7. DIC;
8. Hemoblastoses;
9. aplastic anemia;
10. Taking large doses of anticoagulants.
Ulcerative necrotic syndrome
Ulcerative necrotic syndrome is characterized by the following set of symptoms: - Pain in the oral mucosa;
- Bleeding from the gums;
- Inability to eat due to pain in the oral cavity;
- Increase in body temperature;
- chills;
- Bad breath ;
- Discharge and discomfort in the vagina;
- Difficulty defecation.
Intoxication syndrome
Intoxication syndrome is manifested by the following symptoms:- General weakness;
- Fever with chills;
- Prolonged persistent increase in body temperature;
- Malaise;
- Reduced work capacity;
- Pain in the oral mucosa;
- Commonplace symptoms respiratory disease upper respiratory tract.
Ossalgic syndrome
Ossalgic syndrome is characterized by pain in various bones, which at the first stages are stopped by painkillers. As the disease progresses, the pain becomes more intense and is no longer stopped by analgesics, creating difficulty in movement. In the later stages of the disease, the pain is so severe that the person cannot move.Ossalgic syndrome develops when multiple myeloma, as well as bone metastases in lymphogranulomatosis and hemangiomas.
protein pathology syndrome
Protein pathology syndrome is caused by the presence in the blood of a large amount of pathological proteins (paraproteins) and is characterized by the following symptoms: - Deterioration of memory and attention;
- Pain and numbness in the legs and arms;
- Bleeding of the mucous membranes of the nose, gums and tongue;
- Retinopathy (impaired functioning of the eyes);
- Renal failure (in the later stages of the disease);
- Violation of the functions of the heart, tongue, joints, salivary glands and skin.
sideropenic syndrome
Sideropenic syndrome is caused by iron deficiency in the human body and is characterized by the following symptoms:- Perversion of the sense of smell (a person likes the smells of exhaust gases, washed concrete floors, etc.);
- Perversion of taste (a person likes the taste of chalk, lime, charcoal, dry cereals, etc.);
- Difficulty swallowing food;
- muscle weakness;
- Paleness and dryness of the skin;
- Seizures in the corners of the mouth;
- Thin, brittle, concave nails with transverse striation;
- Thin, brittle and dry hair.
Plethoric syndrome
Plethoric syndrome is manifested by the following symptoms: - Headache;
- Feeling of heat in the body;
- Congestion of blood to the head;
- Red face;
- Burning in fingers;
- Paresthesia (feeling of goosebumps, etc.);
- Itching of the skin, worse after a bath or shower;
- heat intolerance;
icteric syndrome
Icteric syndrome is manifested by a characteristic yellow color of the skin and mucous membranes. Develops with hemolytic anemia.Lymphadenopathy syndrome
Lymphadenopathy syndrome is manifested by the following symptoms:- Enlargement and soreness of various lymph nodes;
- symptoms of intoxication (fever, headache, drowsiness, etc.);
- sweating;
- Weakness;
- Strong weight loss;
- Pain in the area of an enlarged lymph node due to compression of nearby organs;
- Fistulas with purulent discharge.
Hepato-splenomegaly syndrome
Hepato-splenomegaly syndrome is caused by an increase in the size of the liver and spleen, and is manifested by the following symptoms:- Feeling of heaviness in the upper abdomen;
- Pain in the upper abdomen;
- Increase in the volume of the abdomen;
- Weakness;
- Reduced performance;
- Jaundice (on late stage diseases).
Blood loss syndrome
Hemorrhage syndrome is characterized by profuse or frequent bleeding in the past from various bodies and manifests itself with the following symptoms: - bruises on the skin;
- Hematomas in the muscles;
- Swelling and soreness in the joints due to hemorrhages;
- Spider veins on the skin;
Fever Syndrome
Feverish syndrome is manifested by a prolonged and persistent fever with chills. In some cases, against the background of a fever, a person is worried constant itching skin and pouring sweats. The syndrome accompanies hemoblastosis and anemia.Hematological and bone marrow syndromes
Hematological and bone marrow syndromes are non-clinical because they do not take into account symptoms and are detected only on the basis of changes in blood tests and bone marrow smears. The hematological syndrome is characterized by a change in the normal number of erythrocytes, platelets, hemoglobin, leukocytes and blood ESR. Also characterized by a change percentage various types of leukocytes in the leukoformula (basophils, eosinophils, neutrophils, monocytes, lymphocytes, etc.). Bone marrow syndrome is characterized by a change in the normal ratio of cellular elements of various hematopoietic germs. Hematological and bone marrow syndromes develop in all blood diseases.Enteropathy syndrome
Enteropathy syndrome develops with cytostatic disease and is manifested by various disorders of the intestine due to ulcerative-necrotic lesions of its mucous membrane.Arthropathy Syndrome
Arthropathy syndrome develops in blood diseases, which are characterized by a deterioration in blood clotting and, accordingly, a tendency to bleeding (hemophilia, leukemia, vasculitis). The syndrome develops due to blood entering the joints, which provokes the following characteristic symptoms:- Swelling and thickening of the affected joint;
- Pain in the affected joint;
Blood tests (blood counts)
To detect blood diseases, fairly simple tests are performed with the definition of certain indicators in each of them. So, today, the following tests are used to detect various blood diseases: 1. General blood analysis
- The total number of leukocytes, erythrocytes and platelets;
- Leukoformula calculation (percentage of basophils, eosinophils, stab and segmented neutrophils, monocytes and lymphocytes in 100 counted cells);
- The concentration of hemoglobin in the blood;
- The study of shape, size, color and other quality characteristics erythrocytes.
3. Platelet count.
4. Pinch test.
5. Duke bleeding time.
6. Coagulogram with the definition of parameters such as:
- The amount of fibrinogen;
- Prothrombin index (PTI);
- International Normalized Ratio (INR);
- Activated partial thromboplastin time (APTT);
- Kaolin time;
- Thrombin time (TV).
8. Myelogram - taking the bone marrow with the help of a puncture, followed by the preparation of a smear and counting the number of various cellular elements, as well as their percentage per 300 cells.
In principle, the listed simple tests allow you to diagnose any blood disease.
Definition of some common blood disorders
Very often, in everyday speech, people call certain conditions and reactions of the blood diseases, which is not true. However, not knowing the subtleties medical terminology and features of precisely blood diseases, people use their own terms, denoting the condition they have or those close to them. Consider the most common such terms, as well as what they mean, what kind of condition it is in reality and how it is correctly called by practitioners.Infectious blood diseases
Strictly speaking, only mononucleosis, which is relatively rare, is classified as infectious blood diseases. By the term "infectious diseases of the blood" people mean the reactions of the blood system in various infectious diseases of any organs and systems. That is, an infectious disease occurs in any organ (for example, tonsillitis, bronchitis, urethritis, hepatitis, etc.), and certain changes appear in the blood, reflecting the reaction of the immune system.Viral blood disease
viral disease blood is a variation of the process that people refer to as "infectious blood disease". In this case, the infectious process in any organ, which affects the parameters of the blood, was caused by a virus. Chronic blood pathology
By this term, people usually mean any changes in blood parameters that have existed for a long time. For example, a person may have a long-term elevated ESR, but any clinical symptoms and there are no obvious diseases. In this case, people believe that we are talking about a chronic blood disease. However, this is a misinterpretation of the available data. In such situations, there is a reaction of the blood system to some pathological process occurring in other organs and simply not yet identified due to the lack of clinical symptoms that would allow the doctor and patient to navigate the direction of the diagnostic search.Hereditary (genetic) blood disorders
Hereditary (genetic) blood disorders in everyday life are quite rare, but their range is quite wide. So, hereditary blood diseases include the well-known hemophilia, as well as Marchiafava-Mikeli disease, thalassemia, sickle cell anemia, Wiskott-Aldrich syndrome, Chediak-Higashi syndrome, etc. These blood diseases, as a rule, are manifested from birth.Systemic blood diseases
"Systemic blood diseases" - doctors usually write a similar wording when they have detected changes in a person's tests and mean exactly the pathology of the blood, and not any other organ. Most often, this wording hides the suspicion of leukemia. However, as such, there is no systemic blood disease, since almost all blood pathologies are systemic. Therefore, this wording is used to denote a doctor's suspicion of a blood disease.Autoimmune blood diseases
Autoimmune blood diseases are pathologies in which the immune system destroys its own blood cells. This group of pathologies includes the following:- Autoimmune hemolytic anemia;
- drug hemolysis;
- Hemolytic disease of the newborn;
- Hemolysis after blood transfusion;
- Idiopathic autoimmune thrombocytopenic purpura;
- Autoimmune neutropenia.
Blood disease - causes
The causes of blood disorders are varied and in many cases are not exactly known. For example, with deficiency anemia, the cause of the disease is associated with a lack of any substances necessary for the formation of hemoglobin. At autoimmune diseases blood cause is associated with a malfunction of the immune system. With hemoblastoses, the exact causes, as with any other tumors, are unknown. In the pathology of blood coagulation, the causes are a deficiency of coagulation factors, platelet defects, etc. Thus, it is simply impossible to talk about some common causes for all blood diseases.Treatment of blood diseases
Treatment of blood diseases is aimed at correcting violations and the most complete restoration of all its functions. At the same time, there is no general treatment for all blood diseases, and the tactics of therapy for each specific pathology is developed individually.Prevention of blood diseases
Prevention of blood diseases consists in maintaining a healthy lifestyle and limiting the impact negative factors environment, namely: - Identification and treatment of diseases accompanied by bleeding;
- Timely treatment of helminthic invasions;
- Timely treatment of infectious diseases;
- Complete nutrition and intake of vitamins;
- Avoidance of ionizing radiation;
- Avoid contact with harmful chemicals (paints, heavy metals, benzene, etc.);
- Avoidance of stress;
- Prevention of hypothermia and overheating.
Common blood diseases, their treatment and prevention - video
Blood diseases: description, signs and symptoms, course and consequences, diagnosis and treatment - video
Blood diseases (anemia, hemorrhagic syndrome, hemoblastosis): causes, signs and symptoms, diagnosis and treatment - video
Polycythemia (polycythemia), elevated hemoglobin in the blood: causes and symptoms of the disease, diagnosis and treatment - video
Before use, you should consult with a specialist.1. ANEMIA SYNDROME (GENERAL ANEMIC).
Definition: A symptom complex caused by a decrease in hemoglobin and erythrocytes per unit volume of blood with a normal or reduced volume of circulating blood.
Causes: Blood loss (acute and chronic). Violation of blood formation (deficiency or inability to use iron, vitamins (B 12 and folic acid), hereditary or acquired (chemical, radiation, immune, tumor) damage to the bone marrow.Increased blood destruction (hemolysis).
Mechanism: Reduction of hemoglobin functioning in the body - hypoxia - compensatory activation of the sympathoadrenal, respiratory and circulatory systems.
Complaints: General weakness, dizziness, shortness of breath, palpitations, tinnitus.
Inspection. Paleness of the skin and mucous membranes. Dyspnea. Palpation, pulse of weak filling, quickened, filiform. Decreased blood pressure.
Percussion: Expansion of relative cardiac dullness to the left (anemic myocardial dystrophy).
Auscultation. Heart sounds are muffled, quickened. Systolic murmur at the apex of the heart and large arteries. Laboratory data:
In the general blood test: a decrease in the content of erythrocytes and hemoglobin, an increase in POPs. Depending on the etiology, taking into account the color index, anemia can be hypochromic, normochromic, hyperchromic.
2. TISSUE IRON DEFICIENCY SYNDROME.
Definition: Combines the symptoms caused by a lack of iron in tissues, excluding hematopoietic tissue.
Causes: Chronic blood loss, increased iron breakdown (pregnancy, lactation, growth period, chronic infections, tumors), iron absorption disorders (gastric resection, enteritis), iron transport.
Mechanism: Iron deficiency is a violation of the activity of numerous tissue iron-containing enzymes.
Complaints: Decreased appetite, difficulty in swallowing, taste perversion - addiction to chalk, lime, coal, etc.
Inspection: Smoothness of the papillae of the tongue. Dryness of mucous membranes. Dryness, brittle hair. Striation, brittleness and change in the shape of the nails. Cracks in the corners of the mouth.
Palpation: Dry skin, peeling.
Percussion: Expansion of relative cardiac dullness to the left.
Auscultation: Heart sounds are muffled, quickened.
Laboratory data: In the blood: Decrease in the level of serum iron, increase in the total iron-binding capacity of serum.
In the general blood test: hypochromic anemia, microcytosis, anisocytosis, poikilocytosis.
Instrumental research.
Esophagogastrofibroscopy: atrophic gastritis.
Examination of gastric juice: decrease in gastric secretion (basal and stimulated).
3. HEMOLYSIS SYNDROME.
Definition: Symptom complex due to increased breakdown of red blood cells.
Causes: Congenital diseases with a change in the shape of red blood cells (microspherocytosis, thalassemia, sickle cell anemia); paroxysmal nocturnal hemoglobinuria, marching hemoglobinuria, poisoning with hemolytic poisons, heavy metals, organic acids; malaria; immune hemolytic anemia.
Mechanism:
a) increased breakdown of erythrocytes in spleen cells - an increase in the formation of indirect bilirubin,
b) the breakdown of erythrocytes inside the vessels - the entry of free hemoglobin and iron into the blood plasma.
Complaints: Darkening of urine (permanent or paroxysmal), pain in the left hypochondrium, possible chills, vomiting, fever, intense color of feces.
Examination: Icteric staining of the skin and mucous membranes.
Palpation: Enlargement mainly of the spleen, to a lesser extent - the liver.
Laboratory data:
In blood plasma: the content of indirect bilirubin or free hemoglobin and iron is increased.
In the blood: an increase in reticulocytes, pathological forms of erythrocytes, a decrease in the osmotic stability of erythrocytes; normal color index.
In urine: increased content of stercobilin or hemosiderin. To exclude the immune etiology of hemolysis, the Coombs test and the aggregate hemagglutination test (detection of antibodies to erythrocytes) are used.
4. HEMORRHAGIC SYNDROME.
Definition: Symptom complex, which is based on increased bleeding.
Causes: Thrombocytopenic purpura (immune origin, or symptomatic thrombocytopenia with inhibition of bone marrow cell proliferation (aplastic anemia), with bone marrow replacement with tumor tissue (hemoblastosis, tumor metastases in the bone marrow), with increased platelet consumption (DIC), with a lack of vitamin B 12 or folic acid); thrombopytopathy (often a hereditary dysfunction of platelets); hemophilia (hereditary deficiency of 8, or 9, or 11 plasma coagulation factors), acquired coagulopathy (deficiency of plasma coagulation factors in many infections, severe enteropathy, liver damage, malignant neoplasms); hemorrhagic vasculitis (immunoinflammatory vascular disease); hereditary violation of the vascular wall of a separate localization (Randu-Osler telangiectasia), hemangiomas (vascular tumors).
Mechanism:
I. Reducing the number of platelets or their functional inferiority;
P. Deficiency of coagulation factors in plasma (coagulopathy);
III. Damage to the vascular wall of an immune or infectious-toxic nature (vasopathy).
These 3 mechanisms correspond to 3 variants of hemorrhagic
syndrome (see below):
|
Thrombocytopenia and thrombocytopathy |
coagulopathy |
Vasopathy |
|||||
|
Gingival, nasal, abdominal and uterine bleeding. Hemorrhages into the skin when rubbing the skin with a hand, measuring blood pressure. |
Profuse, spontaneous, post-traumatic and postoperative bleeding. Massive painful hemorrhages in the joints, muscles, fiber. |
Spontaneous hemorrhagic rashes on the skin, often symmetrical. Possibly hematuria. Or persistent bleeding of 1-2 localizations (gastrointestinal, nasal, pulmonary) |
|||||
|
Inspection and palpation |
Painless, non-tense superficial hemorrhages in the skin and mucous membranes, bruises, petechiae. |
The affected joint is deformed, painful on palpation. Contractures, muscle atrophy. Hematomas. |
Eruptions on the skin in the form of small indurations, symmetrical, then acquire a purple appearance due to soaking with blood. After the disappearance of hemorrhage, brown pigmentation persists for a long time. |
||||
|
Laboratory data |
|||||||
|
Bleeding time |
lengthened | ||||||
|
Clotting time |
lengthened | ||||||
|
Symptom of "twist", "pinch" |
Positive |
Negative |
fickle |
||||
|
Quantity platelets | |||||||
|
Retraction of a blood clot |
Weak or missing | ||||||
|
Thromboplast ogram |
Hypocoagulation |
Hypocoagulation | |||||
|
Activirova (standardisi forged) partial plate |
enlarged | ||||||
|
prothrombin |
Possible reduction | ||||||
|
Activate another time recalcification |
enlarged |
enlarged | |||||
|
General blood analysis |
Possible normochromic (acute posthemorrhagic), or hypochromic (chronic iron deficiency anemia) |
Possible normochromic (acute posthemorrhagic) or tapochromic (chronic iron deficiency) anemia |
Normochromic (acute posthemorrhagic) or hypochromic (chronic iron deficiency) anemia is possible. Possible leukocytosis, increased ESR. | ||||
|
Urinalysis: hematuria |
Possible |
Possible |
Possible | ||||
Blood diseases are dangerous, widespread, the most severe of them are generally incurable and lead to death. Why is such a pathology exposed important system body, how circulatory? The reasons are very different, sometimes not even dependent on the person, but accompanying him from birth.
Blood diseases
Blood diseases are numerous and varied in origin. They are associated with the pathology of the structure of blood cells or a violation of their functions. Also, some diseases affect plasma - the liquid component in which cells are located. Blood diseases, the list, the causes of their occurrence are carefully studied by doctors and scientists, some have not been able to determine so far.
Blood cells - erythrocytes, leukocytes and platelets. Erythrocytes - red blood cells - carry oxygen to the tissues of the internal organs. Leukocytes - white blood cells - fight infections and foreign bodies entering the body. Platelets are colorless cells responsible for clotting. Plasma is a proteinaceous viscous fluid that contains blood cells. Due to the serious functionality circulatory system, blood diseases are mostly dangerous and even intractable.
Classification of diseases of the circulatory system
Blood diseases, the list of which is quite large, can be divided into groups according to their area of distribution:
- Anemia. The state is pathological low level hemoglobin (this is the oxygen-carrying component of red blood cells).
- Hemorrhagic diathesis - clotting disorder.
- Hemoblastosis (oncology associated with damage to blood cells, lymph nodes or bone marrow).
- Other diseases that do not belong to the three above.
Such a classification is general, it divides diseases according to the principle of which cells are affected by pathological processes. Each group contains numerous blood diseases, a list of them is included in international classification diseases.
List of diseases affecting the blood
If you list all the diseases of the blood, the list of them will be huge. They differ in the reasons for their appearance in the body, the specifics of cell damage, symptoms, and many other factors. Anemia is the most common pathology that affects red blood cells. Signs of anemia are a decrease in the number of red blood cells and hemoglobin. The reason for this may be their reduced production or large blood loss. Hemoblastosis - most of this group of diseases is occupied by leukemia, or leukemia - blood cancer. During the course of the disease, blood cells are converted into malignant tumors. The cause of the disease has not yet been elucidated. Lymphoma is also an oncological disease, pathological processes take place in lymphatic system leukocytes become malignant.
Myeloma is a blood cancer in which plasma is affected. Hemorrhagic syndromes of this disease are associated with a clotting problem. They are mostly congenital, such as hemophilia. It is manifested by hemorrhages in the joints, muscles and internal organs. Agammaglobulinemia is a hereditary deficiency of serum plasma proteins. Allocate the so-called systemic diseases blood, their list includes pathologies affecting individual body systems (immune, lymphatic) or the entire body as a whole.
anemia
Consider the blood diseases associated with the pathology of erythrocytes (list). Most common types:
- Thalassemia is a violation of the rate of formation of hemoglobin.
- Autoimmune hemolytic anemia - develops as a result of a viral infection, syphilis. Drug-induced non-autoimmune hemolytic anemia - due to poisoning with alcohol, snake venom, toxic substances.
- Iron deficiency anemia - occurs when there is a lack of iron in the body or with chronic blood loss.
- B12 deficiency anemia. The reason is a lack of vitamin B12 due to insufficient intake from food or a violation of its absorption. The result is a disturbance in the central nervous system and the gastrointestinal tract.
- Folate deficiency anemia - occurs due to a lack of folic acid.
- Sickle cell anemia - red blood cells are sickle-shaped, which is serious hereditary pathology. The result is a slowdown in blood flow, jaundice.
- Idiopathic aplastic anemia is the absence of tissue that reproduces blood cells. Possible with exposure.
- Familial erythrocytosis - hereditary disease characterized by an increase in the number of red blood cells.
Diseases of the group of hemoblastoses
These are mainly oncological diseases of the blood, the list of the most common includes varieties of leukemia. The latter, in turn, are divided into two types - acute (a large number cancer cells, functions are not performed) and chronic (it proceeds slowly, the functions of blood cells are performed).
Acute myeloid leukemia - violations in the division of bone marrow cells, their maturation. Depending on the nature of the course of the disease, the following types of acute leukemia are distinguished:
- without maturation;
- with maturation;
- promyelocytic;
- myelomonoblastic;
- monoblast;
- erythroblastic;
- megakaryoblastic;
- lymphoblastic T-cell;
- lymphoblastic B-cell;
- panmyeloid leukemia.
Chronic forms of leukemia:
- myeloid leukemia;
- erythromyelosis;
- monocytic leukemia;
- megakaryocytic leukemia.
The above diseases of the chronic form are taken into account.
Letterer-Siwe disease - the germination of cells of the immune system in different organs, the origin of the disease is unknown.
Myelodysplastic syndrome is a group of diseases that affect the bone marrow, which include, for example,
Hemorrhagic syndromes
- Disseminated intravascular coagulation (DIC) is an acquired disease characterized by the formation of blood clots.
- Hemorrhagic disease of the newborn is a congenital deficiency of a blood clotting factor due to vitamin K deficiency.
- Deficiency - substances that are in the blood plasma, mainly these include proteins that ensure blood clotting. There are 13 types.
- Idiopathic Characterized by discoloration of the skin due to internal bleeding. Associated with low platelets in the blood.
Damage to all blood cells
- Hemophagocytic lymphohistiocytosis. A rare genetic disorder. It is caused by the destruction of blood cells by lymphocytes and macrophages. The pathological process occurs in different organs and tissues, as a result, the skin, lungs, liver, spleen, and brain are affected.
- caused by infection.
- cytostatic disease. It is manifested by the death of cells that are in the process of dividing.
- Hypoplastic anemia is a decrease in the number of all blood cells. Associated with cell death in the bone marrow.
Infectious diseases
The cause of blood diseases can be infections that enter the body. What are infectious diseases of the blood? List of the most common:
- Malaria. Infection occurs during a mosquito bite. Microorganisms entering the body infect red blood cells, which are destroyed as a result, thereby causing damage to internal organs, fever, chills. Usually found in the tropics.
- Sepsis is the term used to refer to pathological processes in the blood, the cause of which is the penetration of bacteria into the blood in large numbers. Sepsis occurs as a result of many diseases - it is diabetes, chronic diseases, diseases of internal organs, injuries and wounds. The best defense against sepsis is a good immune system.
Symptoms
Typical symptoms of blood diseases are fatigue, shortness of breath, dizziness, loss of appetite, tachycardia. With anemia due to bleeding, dizziness, severe weakness, nausea, fainting occur. If we talk about infectious diseases of the blood, the list of their symptoms is as follows: fever, chills, itching of the skin, loss of appetite. At long course disease, weight loss is observed. Sometimes there are cases of perverted taste and smell, as in B12 deficiency anemia, for example. There are pains in the bones when pressed (with leukemia), swollen lymph nodes, pain in the right or left hypochondrium (liver or spleen). In some cases, there is a rash on the skin, bleeding from the nose. In the early stages of a blood disorder, there may be no symptoms.
Treatment
Blood diseases develop very quickly, so treatment should begin immediately after diagnosis. Each disease has its own specific features, therefore, the treatment is prescribed in each case. The treatment of oncological diseases, such as leukemia, is based on chemotherapy. Other methods of treatment are blood transfusion, reducing the effect of intoxication. During treatment oncological diseases blood transplants use stem cell transplants derived from bone marrow or blood. This latest way fighting the disease helps to restore immune system and, if not to overcome the disease, then at least prolong the life of the patient. If the tests allow you to determine which infectious blood diseases the patient has, the list of procedures is aimed primarily at eliminating the pathogen. This is where antibiotics come in.
Causes
There are numerous diseases of the blood, the list of them is long. The reasons for their occurrence are different. For example, diseases associated with the problem of blood clotting are usually hereditary. They are diagnosed in children early age. All infectious diseases of the blood, the list of which includes malaria, syphilis and other diseases, are transmitted through the carrier of the infection. It can be an insect or another person, a sexual partner. such as leukemia, have unexplained etiology. Blood diseases can also be caused by radiation, radioactive or toxic poisoning. Anemia can occur due to poor nutrition, which does not provide the body with the necessary elements and vitamins.
