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Zhang Xiao Le
Hematology
About me
Associate Chief Physician, obtained a master's degree from Shandong University in 2009, and has been working at Liaocheng People's Hospital. In 2012, went to Peking University People's Hospital for further training in hematopoietic stem cell transplantation.
Proficient in diseases
Familiar with common blood system diseases such as acute leukemia, lymphoma, multiple myeloma, aplastic anemia, myelodysplastic syndromes, various anemia diseases, and platelet disorders; skilled in using hematopoietic stem cell transplantation technology to treat various blood system diseases, with over 200 cases of involvement in hematopoietic stem cell transplantation.
Voices
Mediterranean anemia has symptoms such as fatigue, paleness, delayed growth, and facial bone deformities.
Thalassemia is a hereditary hemolytic anemia, and the symptoms of patients with thalassemia are related to their specific types. Thalassemia can be divided into mild, intermediate, and severe types. Mild thalassemia clinically may have no symptoms or only mild anemia, sometimes accompanied by mild splenomegaly; Intermediate thalassemia can present with moderate anemia, noticeable fatigue, and splenomegaly, with a few cases experiencing mild skeletal changes and delayed sexual development; Severe thalassemia in children manifests within the first half-year after birth with pallor, progressively worsening anemia, jaundice, hepatosplenomegaly, delayed growth and development, and distinctive facial features such as frontal bossing, a depressed nasal bridge, and increased distance between the eyes.
What is the fastest way to treat iron deficiency anemia?
The treatment of iron deficiency anemia mainly includes two aspects: one is iron supplementation, and the other is identifying and correcting the underlying cause of the anemia. Iron supplementation for patients with iron deficiency anemia can be administered orally or via intravenous infusion, the latter of which tends to be faster. Generally, hemoglobin begins to rise about a week after treatment starts, and returns to normal levels within two to three weeks. Even after hemoglobin levels normalize, iron supplementation should continue for three to six months. It is more important to identify and treat the underlying causes of anemia. Common causes of iron deficiency anemia include chronic blood loss, such as from gastrointestinal ulcers or tumors. Therefore, patients with iron deficiency anemia typically need to undergo gastrointestinal endoscopy to identify the specific cause of the iron deficiency.
The difference between chronic granulocytic leukemia and leukemia
Chronic granulocytic leukemia is a type of leukemia, which itself is a group of malignant clonal disorders of hematopoietic stem cells. In leukemia, the leukemic cells exhibit enhanced self-renewal, uncontrolled proliferation, and obstructed apoptosis, causing a halt at various stages of cell development. Leukemia is divided into acute leukemia and chronic leukemia. Acute leukemia includes acute lymphoblastic leukemia and acute myeloid leukemia, while chronic leukemia includes chronic lymphocytic leukemia and chronic granulocytic leukemia. The primary difference between acute and chronic leukemia is that the leukemic cells in acute leukemia mainly stall at the primitive and immature stages, whereas in chronic leukemia, the cells primarily remain at the mid-immature and late-immature stages.
The differences between aplastic anemia and megaloblastic anemia.
Aplastic anemia is a type of bone marrow failure syndrome where patients can present with reduced total blood cells in the peripheral blood, without enlargement of the liver, spleen, or lymph nodes, and an increased ratio of peripheral blood lymphocytes. Bone marrow indicates low regeneration, reduced hematopoietic tissue, and increased non-hematopoietic tissue, with the condition arising from changes in the bone marrow microenvironment leading to a reduction in blood cells. Megaloblastic anemia, also known as nutritional anemia, is primarily caused by a lack of folate and vitamin B12, leading to a red blood cell synthesis disorder and resulting in anemia. Severe megaloblastic anemia can also present with reduced total blood cells. However, the red blood cells typically exhibit macrocytic anemia. In contrast, aplastic anemia generally presents with normocytic anemia.
Are the liver and kidney functions normal in patients with aplastic anemia?
Patients with aplastic anemia generally have normal liver and kidney functions. However, in certain special circumstances, abnormalities in liver and kidney functions may occur, including: Firstly, the routine treatment for aplastic anemia mainly includes the immunosuppressant cyclosporine and the hematopoietic stimulant androgens. The primary side effect of cyclosporine is renal toxicity. Therefore, during the use of cyclosporine, it is necessary to monitor the concentration of cyclosporine; excessive levels can lead to renal dysfunction. Androgens, including stanozolol and danazol, primarily cause hepatic toxicity; hence, it is necessary to monitor liver and kidney functions during treatment of aplastic anemia. The second factor that may cause liver and kidney function abnormalities is severe anemia. Long-term severe anemia can lead to tissue ischemia and hypoxia in the liver or kidneys, and if prolonged, it can cause abnormalities in liver and kidney functions. (Medication use should be carried out under the guidance of a physician.)
Differentiation between Leukemoid Reaction and Leukemia
Leukemoid reactions and acute leukemia can both present with fever and elevated white blood cell counts, but there are clear differences between the two. Leukemoid reactions are often caused by severe bacterial or viral infections, with the main symptom being fever. Blood tests may show an increase in white blood cells, primarily neutrophils, and peripheral blood smear can reveal myelocytes and metamyelocytes. Leukemia can also involve an increase in white blood cells and fever when there is a concurrent infection, but blood tests will also show reductions in hemoglobin and platelets. Neutrophil alkaline phosphatase score is significantly elevated in patients with leukemoid reactions, while it is generally normal in patients with leukemia. A bone marrow examination can easily differentiate between leukemoid reactions and leukemia.
Does iron deficiency anemia cause a yellow complexion?
No matter what type of anemia, it manifests as a decrease in hemoglobin. Red blood cells are the main cells that carry oxygen, so patients with anemia will have signs of ischemia and hypoxia to some extent, and anemia manifests as pallor in the skin and mucous membranes. Since Chinese are of the yellow race, the manifestation of anemia in Chinese patients often appears as a yellowish complexion. Therefore, patients with iron deficiency anemia can have a yellowish complexion. Of course, if there is obvious yellowing of the skin and sclera in addition to the yellowish complexion, further tests such as hemolysis indicators are needed to rule out hemolytic anemia, as patients with hemolytic anemia often have concurrent jaundice.
How to rule out lymphoma in children
Lymphoma is a malignant tumor originating from the lymphatic system. The main clinical manifestation is painless lymph node enlargement, which can occur in superficial lymph nodes such as in the neck, armpits, or groin, as well as deeper lymph nodes in the mediastinum or abdominal cavity. In pediatric patients with lymphoma, a significant number also present with abdominal pain, intestinal obstruction, or intussusception, which often indicates intestinal lymphoma. If children exhibit lymph node enlargement or deep lymph node enlargement is discovered through imaging studies, it is necessary to perform a puncture or biopsy and conduct a pathological examination to further confirm whether it is lymphoma.
What is good to eat for iron deficiency anemia?
The treatment of iron deficiency anemia mainly includes two aspects. One is the treatment targeted at correcting anemia caused by iron deficiency, and the other is identifying the cause of iron deficiency in the body and correcting it. Iron deficiency anemia is caused by chronic blood loss and a relative deficiency in iron intake due to increased iron demand in the body, which leads to reduced red blood cell production. The main treatment is to supplement with iron-rich medications, and one can also consume more lean meat, pork liver, duck blood, spinach, black fungus, and other foods rich in iron. For patients with iron deficiency anemia, it is crucial to identify the cause of the iron deficiency and provide targeted treatment to fundamentally resolve the issue of iron deficiency anemia.
Does aplastic anemia easily cause oral ulcers?
Patients with aplastic anemia are more prone to oral ulcers. Aplastic anemia is a type of bone marrow failure syndrome, where there is a decrease in white blood cells, red blood cells, and platelets in the peripheral blood to various extents. Long-term anemia can lead to mucosal ischemia and hypoxia. The reduction in white blood cells weakens the mucosal barrier's protective function, making it susceptible to bacterial invasion and thus prone to oral ulcers. Additionally, patients with anemia often have poor diets over long periods, leading to a deficiency in various vitamins, which is another reason why they are prone to oral ulcers. If symptoms like joint pain are present along with oral ulcers, further rheumatological and immunological tests should be conducted to rule out rheumatic and immune system diseases.