Blood diseases constitute a numerous and heterogeneous group of syndromes that develop with violations of the qualitative and quantitative composition of blood. The practical direction developing the principles of diagnosis and treatment of blood diseases is hematology and its separate branch – oncohematology. Specialists who carry out correction of the state of blood and hematopoietic organs are called hematologists. Hematology has the closest interdisciplinary connections with internal diseases, immunology, oncology, and transfusiology.

Since ancient times, in many cultures, human blood was endowed with mystical properties, symbolized the divine source and flow of life. “Precious”, “hot”, “innocent”, “young”, “royal” – whatever properties people gave blood, and the epithet “blood” always meant the highest degree of certain manifestations – blood kinship, blood enemy, blood grudge, blood revenge.

Meanwhile, from the point of view of physiology, blood is a liquid medium of the body that continuously circulates through the vascular system and performs a number of important functions – respiratory, transport, regulatory, protective, etc. Blood consists of a liquid fraction – plasma and shaped elements suspended in it – blood cells (erythrocytes, platelets and leukocytes). The main organs of hematopoiesis (hemocytopoiesis), which are a kind of “factory” for the production of blood cells, include the red bone marrow, thymus, lymphoid tissue and spleen. Blood diseases are spoken of in the case of a violation of the morphology or the number of certain blood cells or changes in the properties of plasma.

All diseases of the blood and hematopoietic system are classified based on the defeat of one or another of its components. In hematology, blood diseases are usually divided into three large groups: anemia, hemoblastosis and hemostasiopathy. So, frequent anomalies and lesions of erythrocytes include deficient, hemolytic, hypo– and aplastic anemia. The structure of hemoblastoses includes leukemias and hematosarcomas.

Blood diseases associated with damage to the hemostatic system (hemostasiopathy) include hemophilia, Willebrand’s disease, thrombocytopathies, thrombocytopenia, DIC syndrome, etc.

Blood diseases can be congenital and acquired in nature. Congenital diseases (sickle cell anemia, thalassemia, hemophilia, etc.) are associated with gene mutations or chromosomal abnormalities. The development of acquired blood diseases can be triggered by numerous environmental factors: acute and chronic blood loss, exposure to ionizing radiation or chemical agents, viral infections (rubella, measles, mumps, influenza, infectious mononucleosis, typhoid fever, viral hepatitis), nutritional deficiency, impaired absorption of nutrients and vitamins in the intestine, etc. When bacterial or fungal agents enter the bloodstream, a serious blood disease of infectious genesis occurs – sepsis. Many blood diseases go hand in hand with collagenoses.

The manifestations of blood diseases are many-sided and not always specific. Characteristic signs of anemia are causeless fatigue and weakness, dizziness up to fainting, shortness of breath during physical exertion, pallor of the skin. Disorders of the blood coagulation link are characterized by petechial hemorrhages and ecchymoses, various kinds of bleeding (gingival, nasal, uterine, gastrointestinal, pulmonary, etc.). In the leukemia clinic, intoxication or hemorrhagic syndromes come to the fore.

The very first method with which the diagnosis of blood diseases begins is the study of a hemogram (clinical analysis) with the determination of the quantitative composition of blood and the morphology of the shaped elements. In blood diseases occurring with hemostasis disorders, the number of platelets, blood clotting and bleeding time, prothrombin index, coagulogram are examined; various kinds of tests are carried out – a tourniquet test, a pinch, a cupping test, etc.

To assess the changes occurring in the hematopoietic organs, bone marrow puncture (sternal puncture, iliac puncture, trepanobiopsy) is used with the study of its cellular composition. In connection with blood diseases, other invasive diagnostic interventions may be performed: biopsies of the lymph nodes and spleen to clarify the relationship between the central and peripheral hematopoietic organs.

Radiation research methods (chest X-ray and CT, radiography of tubular bones) are used to detect enlarged mediastinal lymph nodes in lymphogranulomatosis, lymphosarcoma, lymphocytic leukemia; bone lesions in lymphomas, myeloma, etc. To assess the size, function of the spleen and identify its focal lesions, scintigraphy is performed. As part of the investigation of the causes of the anemia syndrome, patients may need to consult a gastroenterologist and gynecologist; FGDS, colonoscopy, liver ultrasound.

Any changes in the hemogram or myelogram, as well as symptoms indicating the likelihood of developing blood diseases, require a competent assessment by a hematologist, dynamic observation or specialized treatment under his supervision. Modern hematology has developed the fundamental principles of therapy for various blood diseases and has accumulated vast experience in their cure. If possible, the treatment of blood diseases begins with the elimination of causes and risk factors, correction of internal organs, replenishment of missing substances and trace elements (iron – with iron deficiency anemia, vitamin B12 – with B12 deficiency anemia, folic acid – with folic deficiency anemia, etc.).

In some cases, corticosteroids, hemostatic drugs, extracorporeal hemocorrection (plasmapheresis, erythrocytapheresis) may be indicated. Often, hematological patients need blood transfusion and its components.

Cytostatic therapy, radiotherapy, allogeneic and autologous bone marrow transplantation, and the introduction of stem cells are the most relevant and effective methods of treating hematoblastosis worldwide. A number of blood diseases (thrombocytopenic purpura, autoimmune anemia, myeloid leukemia, etc.) are indications for spleen removal – splenectomy.

With the current level of development of medical science, most blood diseases can be cured and prevented. To do this, it is necessary to take a general blood test every year, immediately consult a doctor when the first alarming symptoms appear, do not start the course of chronic diseases (erosive gastritis, gastric ulcer, enteritis, NYAK, hemorrhoids, uterine fibroids, etc.). It is necessary to avoid exposure to adverse environmental factors on the body. To exclude the birth of offspring with congenital blood diseases, medical and genetic consultations are conducted.
In this section of the medical reference book “Medic Journal” you will be able to find answers to the main questions concerning blood diseases, get acquainted with the main nosological forms, symptoms, principles of diagnosis and treatment.

Acute Leukemia

Acute leukemia is a tumor lesion of the hematopoietic system, the morphological basis of which are immature (blast) cells that displace normal hematopoietic sprouts. Clinical symptoms are represented by progressive weakness, unmotivated fever, arthralgias and ossalgias, bleeding of various localizations, lymphadenopathy, hepatosplenomegaly, gingivitis, stomatitis, angina. To confirm the diagnosis, it is necessary to examine the…

Myelofibrosis

Myelofibrosis is a chronic hematological disease characterized by tumor proliferation of hematopoietic stem cells and bone marrow fibrosis. The main clinical manifestations include symptoms of tumor intoxication and anemic syndrome (progressive weakness, pallor of the skin and mucous membranes, weight loss), as well as enlargement of the spleen (splenomegaly). The diagnosis is established on the…

Myeloma

Myeloma is a malignant proliferation of mature differentiated plasma cells, accompanied by increased production of monoclonal immunoglobulins, infiltration of the bone marrow, osteolysis and immunodeficiency. Disease occurs with pain in the bones, spontaneous fractures, the development of amyloidosis, polyneuropathy, nephropathy and CRF, hemorrhagic diathesis. The diagnosis is confirmed by the data of radiography of the…

Methemoglobinemia

Methemoglobinemia is a condition characterized by an increased content of methemoglobin (oxidized hemoglobin) in the blood and tissue hypoxia. The development of the disease is accompanied by acrocyanosis, weakness, headaches, dizziness, palpitations, shortness of breath during exercise. A characteristic feature of the pathology is the brown-chocolate color of the blood. To confirm the diagnosis, an…

Radiation Sickness

Radiation sickness is a complex of general and local reactive changes caused by the effect of increased doses of ionizing radiation on cells, tissues and the environment of the body. Radiation sickness occurs with the phenomena of hemorrhagic diathesis, neurological symptoms, hemodynamic disorders, a tendency to infectious complications, gastrointestinal and skin lesions. Diagnosis is based…

Leukemia

Leukemia is a malignant lesion of bone marrow tissue that leads to impaired maturation and differentiation of hematopoietic cells–precursors of leukocytes, their uncontrolled growth and dissemination throughout the body in the form of leukemic infiltrates. Symptoms can be weakness, weight loss, fever, bone pain, causeless hemorrhages, lymphadenitis, splenic and hepatomegaly, meningeal symptoms, frequent infections. The…

Coagulopathy

Coagulopathy are hematological syndromes characterized by a violation of hemostasis by the type of hypo- or hypercoagulation. Hemocoagulation disorders are manifested by hemorrhagic syndrome (nosebleeds, gums, wounds, subcutaneous hemorrhages), thrombosis of various localization. Pathology are diagnosed according to hematological studies: UAC, coagulogram, coagulation factors, platelets, autoantibodies, etc. Therapy depends on the impaired link of hemostasis,…

Iron Deficiency Anemia

Iron deficiency anemia is a syndrome caused by iron deficiency and leading to a violation of hemoglobinopoiesis and tissue hypoxia. Clinical manifestations are represented by general weakness, drowsiness, decreased mental performance and physical endurance, tinnitus, dizziness, fainting, shortness of breath during exercise, palpitation, pallor. Hypochromic anemia is confirmed by laboratory data: a study of clinical…

Disseminated Intravascular Coagulation

Disseminated intravascular coagulation is a disorder of hemostasis associated with hyperstimulation and a shortage of reserves of the blood coagulation system, leading to the development of thrombotic, microcirculatory and hemorrhagic disorders. With disease, there is a petechial hematoma rash, increased bleeding, organ dysfunction, and in acute cases, the development of shock, hypotension, severe bleeding, ODN…

Histiocytosis X

Histiocytosis X is a systemic disease characterized by the formation of specific cellular granulomas in various organs and tissues. The most typical clinical manifestations include skin rashes, cough, unilateral exophthalmos. There is also tooth loss, an increase in peripheral lymph nodes, signs of diabetes insipidus (polyuria, polydipsia). The diagnosis is verified by histological examination of…