lejkotsitopenija chronic

[dkn]

Good evening!

At us in unit of the patient of 25 years, an endometriosis, adherent or adhesive process in a small basin, a candidiasis of a vagina, in the anamnesis a clamidiosis, laporoskopija oothecomas.

In current of year on ZGT (for a year has transferred or carried 2 -alimentary infections of average gravity, 2 ORVI concerning easy or light;mild current)

OAK in current of year Leucocytes 3,9...3,4....3,2....2,9

Now 2,4 ESR 18 LF 52 % Segments of 37 %

Other parameters in norm or rate

THROMBUS 140

Coagulogram in norm or rate

Biochemistry of a blood, serumal iron, etc. all the bottom border of norm or rate.

Red blood in norm or rate

What comments and advice or councils by way of conducting the patient in occasion of singing

Whether there is here a classics of a hematology?

Thanks

[Dr. Vad]

The dear/an colleague!



The chronic neutropenia can be an attribute hr. Inflammations or to accompany inflammatory and-or an iron deficiency anemia. If Could you to specify a full heme. The analysis with parameters MCV, MCH, RDW (if is not present a hemoglobin, ages-you, a hematocrit), and also in digits OZHSS and syv. Iron it will be possible to recommend something from treatment.

[Gromoboy]

It is the most probable, that you deal with a consequence of the alimentary toxinfections transferred or carried by the patient led a dysbacteriosis. That was in turn reflected and in structure of a blood. If to let matters drift, in current of rather limited period (6-12 mes) it is necessary to expect occurrence *quot; ??N??*quot; anemias. Practically you now easily will correct a situation purpose or appointment bifidopreparatov.

Inflammation in a small basin - the factor in this case minor, though and playing a part.

[Melnichenko]

From the endocrinologist - I do not ask naive questions, whether the patient accepts analgetiki, I ask-what analgetiki the patient and what such ZGT with reference to the given situation accepts?

[dkn]

The patient does not accept analgetics.

ZGT = replaceable hormonal therapy

[Melnichenko]

What is ZGT with reference to the woman of 25 years with an endometriosis?

[Dr. Vad]

Uv. dkn!



There are complexities with definition OZHSS and publikovaniem digits of a red blood, incl. a hematocrit, and also syv. A gland?

[dkn]

No, complexities are not present, all these data I shall publish later (yet had no opportunity them to get) on memory of AGES 4,0 Nv 122 syv. Iron 9,6 (norm or rate 10 on sew a lab.) a hematocrit in norm or rate (digit I do not remember) the rest it is necessary to look...

ZGT in occasion of a premature menopause (surgical) femoston 2/10

[Dr. Vad]

Anemias obvious are not present, but on evroref. To sizes for women Ayr from 4,1 and above, a hemoglobin from 123 and above, those on these data or pogranitsa or an anemia, not bad the nobility its or her usual (previous) parameters, tk napr. At ind. A hemoglobin 130-135, 122 already an anemia. Iron is lowered can at zhelezodefitsite, then OZHSS high (more than 60) and to begin therapy by peroral iron but if OZHSS 30-40 more likely these disturbances either an inflammatory genesis or a combination, then to try pentoksifillin up to 1,2 g/?OO. And to look or see for an ESR: will start to decrease, OZHSS-raise, then peroral therapy by iron. At failures - or koloniestim.faktory or a carbonate of a lithium.

[dkn]

spaibo.

Before it or she had a chronic anemia (with solov the patient all life) 110-115 Ayr 3,7...9 now she (a floor of year back) the picture positive, imho for it or her these borders (digits) rather normal received therapy by iron preparations apparently.

[Dr. Vad]

Half a year of therapy by peroral iron about what do not speak: usually perorally preparations are appointed or nominated under the control of reticulocytes or risings of erythrocytes/hemoglobins, if during 1-3 ned. Parameters do not raise or increase, the peroral way is not effective. In this case, I do not exclude, that they, darling, went as transit goods with the minimal mastering: so it is possible to be treated also year unsuccessfully. On the other hand low iron whence is, and without OZHSS or a peroral iron load here to not understand. Iron is necessary for normal granulotsitopoeza also, therefore or it is necessary to understand what here anemias more: inflammatory or ZHD with disturbance of an absorption or to go on a way of stimulation of KM plus parenteralno iron.