Saturday, July 29, 2017

Hemarthrosis, bleeds and clots

I recently read a post on FB from a lady with ET who had suffered from hemarthrosis, so I did a little digging to learn more.

Hemarthrosis is when you have blood hemorrhaging into your joints. It happens to hemophilia patients. It can also happen, though rarely, to those with ET, so it's something to be aware of but not overly concerned about.

It wasn't easy to find info on hemarthrosis in ET patients; I only found one article from 2012 ("How I Manage Essential Thrombocytosis" in the journal Leukemia.)

Hemarthrosis isn't fun. Like any swellimg in a joint, it is painful and can come on with no reason, or because you fell on or injured a knee, shoulder, hip, or elbow--places where hemarthrosis typically occur.

Swelling, bruising, pain, poor range of motion--all of these can be signs of hemarthrosis. If you have any of them, see your doc and remind him or her that you have ET. Or, if the doctor asks if you have a bleeding disease, your answer should be "yes, I have ET."

More than likely, joint swelling is not hemarthrosis, but get it checked. The doctor may want to drain some of the fluid from around the joint to see if it's clear or bloody. Even if it's clear, your doctor will want to prescribe some treatment to prevent damage.

One of the interesting things I found out on the way to learning about hemarthrosis is that while clots are the most common complications for ET patients, it's hard to predict whether clots will occur based on your platelet counts. Some people have had clots with lower platelet counts. Some don't clot with counts even over a million. Age and the type of mutation you have (JAK2 or CALR) are better predictors of clot risk than platelet counts; remember JAK2 patients clot more frequently than CALR patients.

However, very high platelet counts (1 million or more) are more reliable predictors of bleeding incidents (like hemarthrosis as well bleeds in the brain or GI tract). This info underscores the need to reduce platelet counts with chemotherapy. It also emphasizes the danger of trying to reduce platelets with "natural" treatments. They won't bring your platelet levels low enough to prevent complications.

Be well!





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ET is a serious disease that requires specialist care. Discuss anything you read here with your doctor. No comments promoting "alternative" or "natural" cures (yes, this includes Rick Simpson's Oil) will be published.