[Mingpao News]The new crown epidemic has subsided slightly, and society is gradually returning to normal. Recently, the number of patients infected with the new coronavirus has been repeated. Fortunately, most of them are mild and generally recover quickly. People with low immunity should still be careful. After infection, the condition may be serious, and they must be injected with the new crown vaccine on time. (Editor’s note: A recovering breast cancer patient suffered from non-stop nosebleeds after being “acquired” by the new crown earlier. Blood tests showed that the number of platelets dropped sharply to close to zero. The situation…)
Breast cancer survivor infected with the new crown virus keeps nosebleeds and platelets return to zero in critical condition
50-year-old Chen Taitao suffered from breast cancer a few years ago and recovered smoothly after treatment. I was infected with the new crown virus earlier, and my nosebleeds continued after 1 week. A blood test showed that the number of platelets dropped sharply to close to zero, and the situation was critical. Fortunately, the nucleic acid test for the new coronavirus has turned negative, and the level of antibodies to the new coronavirus in the blood is extremely high. A bone marrow biopsy showed normal bone marrow function, and a diagnosis of acute immune thrombocytopenia (acute immune thrombocytopenia) was confirmed, which was believed to be related to the earlier infection with the new coronavirus. Mrs. Chen’s immune system was seriously out of balance, attacking her own platelets, causing the number of platelets to drop sharply.
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Prescription of high-dose steroids, injections of immunoglobulin
The doctor injected intravenous immunoglobulin (intravenous immunoglobulin) for Mrs. Chen to prevent the rapid apoptosis of platelets in the spleen, thereby prolonging the life of the platelets; they also prescribed large doses of steroids to suppress Mrs. Chen’s immune system and prevent immune cells from attacking the platelets. The treatment has achieved results soon, but the platelet count is still repeated; the doctor then prescribes eltrombopag to stimulate the bone marrow to produce more platelets to replenish the consumption. Mrs. Chen’s platelet count has repeatedly increased and reached a safe level, but it is still not stable.
B cells are responsible for producing antibodies, and there is CD20 protein on the cell surface; rituximab is a medicinal monoclonal antibody (monoclonal antibody) against CD20 protein, which can effectively eliminate B cells in the body and reduce the level of antibodies against platelets, which can make Platelet count recovery is another option for the treatment of immune thrombocytopenia.
Removal of the spleen prolongs the lifespan of platelets
The spleen is the site of platelet apoptosis. Splenectomy can prolong the life of platelets in the body and increase the number of platelets. Therefore, it can be used to treat immune thrombocytopenia. After splenectomy, patients have weak immunity and are susceptible to certain bacterial infections, such as Streptococcus pneumoniae (pneumococcus). It is advisable to inject relevant vaccines before the operation to reduce the risk of postoperative infection.
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Text: Liang Xiansun (specialist in hematology and hematology oncology)
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2023-07-18 08:59:08
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