Thrombocytopenia has done bone marrow puncture what to check next

Hello! He was informed of the condition and expressed his concern. There are many reasons for thrombocytopenia: 1. Decreased thrombopoiesis: (1) idiopathic thrombocytopenic purpura, chronic aplastic anemia (CAA) and myelodysplastic syndrome (MDS): some patients may be the first to show For thrombocytopenia and subsequent reduction of other blood cells, bone marrow smears and bone marrow biopsy have certain differential significance. (2) Infection: seen in children with acute idiopathic thrombocytopenic purpura. (3) Decrease of platelet production after radiotherapy and chemotherapy. 2. Increased platelet destruction: (1) Autoimmune diseases: such as systemic lupus erythematosus (SLE), rheumatoid arthritis, Evans syndrome, hyperthyroidism, chronic hepatitis, etc., which cause decreased platelet production. Some patients can lead to thrombocytopenia Symptoms occur, and the corresponding typical symptoms do not appear until months or even years. Therefore, patients with suspected ITP, especially young female patients, should routinely undergo screening tests such as anti-nuclear antibodies and anti-double-stranded DNA antibodies. (2) Antiphospholipid syndrome: thrombocytopenia may also occur first, and then antiphospholipid antibodies and lupus anticoagulant positive, thromboembolism, miscarriage and other manifestations will appear later. (3) Human immunodeficiency virus (HIV): The related thrombocytopenic purpura is also mediated by immune mechanisms. Thrombocytopenia can occur at different stages of asymptomatic carriers and AIDS patients after HIV infection. (4) Drug-induced thrombocytopenia: It can be divided into direct destruction of platelets, bone marrow suppression, and immune thrombocytopenia. May cause bone marrow suppression chemotherapy drugs and other drugs, such as alkylating agents, chloramphenicol, antimetabolites, thiazide diuretics, ethanol, etc. (Such as aspirin, indomethacin, paracetamol and other antipyretic analgesics, penicillin, cephalosporin, sulfa, rifampin antibacterial drugs and heparin, carbamazepine, phenytoin sodium, sodium valproate and other drugs can cause Immune platelets are destroyed, causing thrombocytopenia. Usually the onset is rapid and the bleeding is heavier, but most of the bleeding symptoms disappear quickly after stopping the drug, and hormone therapy often takes effect quickly) 3. Thrombotic thrombocytopenic purpura (TTP) : In addition to thrombocytopenia, typical TTP has manifestations such as microangiopathic hemolysis, neuropsychiatric abnormalities, renal insufficiency, and fever. 4. Abnormal distribution of platelets leads to reduced platelet production: such as hypersplenism, bone marrow fibrosis, liver cirrhosis, etc. lead to splenomegaly, which can cause platelets to stay in the liver and spleen, and abnormal platelet distribution, resulting in decreased platelet production.

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