All About Hematology (Blood Disorders)

Hematology is a Latin word and it means "blood disease". Hematology is a branch of science which studies particularly disorders such as anemia (anemia), bleeding, leukemia (blood cancer, acute and chronic leukemia), multiple myeloma; and together with these bone marrow, lymphatic system and blood-related diseases.

In our clinic;

1. About Anemiea

Iron Deficiency Anemia: Weakness, fatigue, hair loss, nail breakage, lack of attention and loss of appetite for school children, is the most important symptoms. It proceeds depending on the rapid growth in children, more menstrual bleeding in women, pregnancy and gastrointestinal diseases in men. It is easy to diagnose. Divalent iron pills used orally in therapy. For patients who have severe gastrointestinal disease intramuscular or intravenous iron therapy can be applied.Intravenous iron therapy can be applied in our hospital for a period of 5-7 days. Because of the risk of allergy, it would be appropriate to be provided in hospital under medical supervision.

B12 Deficiency: Weakness, fatigue, forgetfulness, numbness hands and feet are the most important symptoms. It can develop on vegetarians, those with stomach disorder due to the use of some drugs. It is easy to diagnose. The treatment can be made after finding the underlying cause of the disease. Treatment is done generally, in the form of intramuscular application.

Folate Deficiency: Clinical and laboratory symptoms are similar to the B12 deficiency. It absolutely has a reason. When folate is deficient, along with anemia, it can cause restless leg syndrome and deficient birth for pregnant women which is called neural tube defects.

Mediterranean Anemia Conductor: (Thalassemia Conductor = Thalassemia Minor = Thalassemia Trait ): It mimics iron deficiency. Does not cause hair loss, nail breakage, etc.Laboratory findings are similar to iron deficiency. Many patients receive iron therapy mistakenly but cannot benefit from treatment. The disease is being diagnosed in our clinic and genetic advisory services are provided.

Hemolytic Anemias= Demolition Induced Anemias:The most important symptoms of this anemia are; weakness, fatigue, jaundice, spleen size and for the patients with gall bladder stone in the early age.In this group diseases take place such as hot type, cold type autoimmune hemolytic anemias, enzyme deficiencies, hereditary spherocytosis, sickle cell anemia.

Aplastic Anemia: It is a disease which occur in the bone marrow when the blood cells in erythrocytes, leukocytes and platelets (white cells, red cells and platelets) cannot produced. Fatigue, bleeding, fever are the most important symptoms. Diagnosis is made by bone marrow biopsy. For treatment drug therapy and bone marrow transplantation are required.Diagnosis of the disease and drug treatment are offered in our hospital.

Anemia of Chronic Disease: It is an anemia which seen on the patients who has cancer, tuberculosis, rheumatic diseases, kidney disease, liver disease and diabetes.It is a major cause of anemia. Diagnosis and treatment of such patients are offered in our clinic and underlying diseases can be treated. For patients who has very low blood can be made via observation or blood transfusion by inpatient treatment.

2. Bleeding Diseases

Bleeding diathesis / trend can be congenital or post facto.

The most important symptoms in these patients are;

  • Petechiae (Bleeding in the form of a Pinhead)
  • Purpura (Bleeding 2-3 mm),
  • Ecchymosis (Large Bruises),
  • Epistaxis,
  • Gingival Bleeding
  • Long menstruation period and large amount of bleeding (more than 7 days, more than seven contaminated pet clients, using diapers, be down with due to bleeding),
  • Stomach, bowel bleeding,
  • Non-stopping bleeding after circumcision or tooth extraction,
  • Intra-articular bleeding,
  • Intramuscular bleeding,
  • It is a bleeding not stop easily after surgery and when cut anywhere on body.
  • For the patients who have this types of symptoms it would be useful to take a check-up, for not to suffer from further problems.
  • In this group, test for the hemophilia, Von- Willebrand disease, thrombocytopenia, platelet dysfunction can also be done.

3 Immune Thrombocytopenia

It can be seen frequently on children, young people and women. It begins with a sudden onset of petechiae, purpura, bruising and nosebleeds, bleeding gingival bleeding. The reason is not clear. The lower number of platelets in the blood (blood platelets) are the most important symptom. ITP diagnosis and treatment is performed in our hospital. The primary treatment of disease is cortisol treatment. In our hospital at the resistant condition for the treatment, patient prepared for the operation and there can be applied laparoscopy (closed method) splenectomy.

4 Hereditary Thrombophilia (Coagulation Tendency)

It is a disease which has a genetic tendency to coagulation. Under 45 years, arterial or venous (arterial or venous) congestion, congestion in the brain vessels, stroke undergoing, those with vascular obstruction in the eye and loss of vision, associated with blockages in heart arteries and have an heart attack patients, obliteration at unexpected region of the body due to coagulation, ovarian veins, cavernous sinus thrombosis, thrombosis on the arm, on the patients whose lungs excrete clots (pulmonary embolism) and the HEREDITARY THROMBOPHILIA SHOULD NECEESSARILY BE SOUGHT ON THOSE WHO HAD TWO OR MORE ABORTIONS WITH UNCLEAR REASON. The reason of the abortion or non-fecundability can be due to the insufficient blood build up as a result of the non-coagulation of uterus veins. This causes the fertilized egg inability to hold up well, even if hold up, to fall because of the lack of nutrition.

Coagulation in patients with hereditary thrombophilia often develops due to sitting for long periods, air travelling, after surgery and birth control pills. Such patients must be certainly investigated whether there is a genetic tendency to coagulation or not. In our hospital innate tendency to clot-forming factor V Leiden, mutation gene prothrombin, mutation gene MTHFR, mutation gene PAI-1, protein C, anti-thrombin III levels can be measured. Pregnancy and thrombophilia patients are being followed closely by our gynecology experts so their treatment and follow-up can be done.

5 Acute Leukemia

AML (acute myeloid leukemia) and ALL (acute lymphoblastic leukemia) are divided into two groups. AML is in adults and the ALL is most common in children. There is no certain reason. A person can sleep well but wake up with acute leukemia in the morning. The most important symptoms are fatigue, paleness, diffuse bleeding and fever. At complete blood count, if the number of white blood cells are high, hemoglobin and platelets are low, you can suspect. If not treated, it can cause death in 1-2 months. It is the most severe disease of Hematology. It is a very challenging process for patient, family and physician. In our hospital, there is a diagnosis and treatment of disease. (For these patients who need to take bone marrow transplantation, bone marrow transplant cannot be made, so they are directed to appropriate centers.)

6 Chronic Leukemia (CML (Chronic Myeloid Leukemia) and CLL (Chronic Lymphoid Leukemia))

CML is seen between 40-50 ages. The most important symptoms are weakness, fatigue, weight loss and an enlarged spleen. In conducted tests if leukocyte count is very high, platelet count is slightly higher, you can suspect. Diagnosis of the disease, as a genetic bone marrow or in the blood, which is taken from peripheral blood , can be done with the shown of positive examination of the Philadelphia chromosome. Hematology is a disease which genetics decrypted in the area and has a definitive treatment. Diagnosis of the disease, treatment and follow-up are made in our clinic.

CLL is seen between 60-70 ages. Generally, by chance in routine blood account at patients whose the number of leukocytes is high, hemoglobin and platelet counts are normal in peripheral smear is suspected if there is dominance of lymphocytes. The most important complaints are; common glands in the body, spleen size, common lung infection. The disease is slowly progressing. There are five stages of the disease. Usually the treatment begins, after 10 years from disease begins. Given treatment to the patients who is at stage 4 or 5. Every passing days, there are hope-giving developments about treatment and new drugs are offered to the market. Diagnosis and treatment is performed in our clinic.

7 Essential Thrombocytosis

It is seen between 50-60 ages women. The most important symptom is pain and redness in the palms and soles. Weakness, fatigue, weight loss, fever, blood coagulation, rarely bleeding and spleen size can be seen. During the test if there is an over platelet count in blood, higher than 600 thousand per cubic millimeter, you can be suspicious. Diagnosis of the disease is made by bone marrow research. Treatment is drug therapy. Diagnosis and treatment is performed in our clinic.

8 Lymphomas

It can be seen at any age. But the more age increases, the more incidences increase. There are two sub-groups of the disease. These are Hodgik's Disease and Non Hodgik's lymphoma (NHL). NHL can be seen more common. The most important symptom of the disease is the growth of the lymph nodes. The growthof lymph nodes revealed in a sudden. It can be reach size of potato from size of pea, in months. The growth rate varies from person to person. In a time there is an increases about its size, number and the occurrence. The most commonly arises in the left neck region. But it can also begin in the armpits, groin, abdominal, lymph nodes in the chest cavity. The most important symptoms which accompany the growth of lymph nodes are fever, night sweats, weight loss and itching. LDH levels, high sedimentation, increased eosinophils are important findings. The definitive diagnosis is made by the complete removal of lymph nodes. Needle biopsy is misleading and can cause prolongation of the time. Pathology defines the diagnosis. The treatment can be change according to the pathology result whether it is Hodgikin Disease or NHL. There are many subtypes of the disease, the treatments varies depending on them.

9 Multiple Myeloma

Although it can be seen at any age, this is mainly disease of over the age of 71. The most important symptoms are; low back pain and unexplained bone fractures. Belongs of anemia weakness, fatigue, kidney failure, are the frequent infections. There is a suspecting situation for those whose serum calcium is high while alkaline phosphatase is normal, hyperviscosity signs (headache, dizziness, tinnitus, vision loss) in the laboratory erythrocyte sedimentation rate above of 100 mm /s, and globulin levels higher than albumin levels. A diagnosis of the disease bone marrow biopsy and in urine or blood is made by immunofixation electrophoresis. 4 cycles of medication are given to patients who are under the age of 70. Then autologous bone marrow transplant is performed. Diagnosis and treatment of the disease is made in clinic. (For the patients who are need to bone marrow transplant, are directed to the relevant centers by consultation).

10 Myelodysplastic Syndrome

Hematology is one of the most difficult areas. Elderly patients, who has unexplained macrocytic anemia, is suspected in any patient. The complete blood count of patient, can be found all kinds of cells in peripheral smear and bone marrow. The clinical course of the disease is very different. There can be patients live for years without any problems, while another side there is a patients can return AML or ALL in months. Specific guidelines for shows the course of the disease. Disease diagnosis, follow-up and treatment are performed in our clinic.

Prof. Dr. Ali KOŞAR




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