The procedure is usually performed in a clinic setting. During one session, from 350 to 500 ml of blood is withdrawn. Bloodletting sessions are repeated every 2 days until the desired results are achieved. In the future, blood tests are monitored once every two months. As a result of bloodletting, the iron content in the body decreases. Most often, patients tolerate it well. However, sometimes weakness, hair loss, and severe iron deficiency anemia occur. In this case, iron supplements should be prescribed in combination with cytostatic drugs.
Bloodletting is not prescribed if its effect is small and short-term, or if there are severe signs of prednisolone pills. During this procedure, 1–1.4 liters of blood are taken from the patient’s vascular bed. Red blood cells are removed from it using special equipment. The remaining plasma is brought to the original volume with saline and poured into the venous system. Erythrocytapheresis is an alternative to bloodletting. Courses of such treatment provide an effect for 1-2 years.
In severe cases of the disease, when bloodletting is ineffective, in older peopleCytostatic drugs have been prescribed for 50 years. They inhibit the proliferation of cells in the bone marrow. As a result, the number of all blood cells, including red blood cells, decreases. When treating with cytostatics, blood tests are regularly performed to monitor the effectiveness and safety of prednisolone treatment. The most commonly used are alkylating cytostatics and antimetabolites. Radioactive phosphorus 32P is used less frequently; it is indicated mainly for elderly people.
For vascular thrombosis, antiplatelet agents and heparin are prescribed. For acute thrombophlebitis, local treatment is carried out. cooling the leg with ice packs on the first day, then heparin ointment and Vishnevsky ointment. For severe bleeding, aminocaproic acid, fresh frozen plasma, and a hemostatic sponge are prescribed locally. Erythromelalgia (pain in the tips of the fingers, soles) is treated with NSAIDs (indomethacin, voltaren). Antiplatelet agents and heparin may be prescribed.
In case of cerebrovascular accident, hypertension, gastric ulcer, appropriate medication regimens are used. Antihistamines are used to treat itchy skin. Cimetidine (an H2 receptor blocker) is sometimes effective. Indications for removal of the spleen for erythremia.
Hemolytic anemia and thrombocytopenia. An abnormally enlarged spleen, causing compression of other organs. Repeated splenic infarctions. Portal hypertension with clinical manifestations. If you find signs that resemble erythremia, contact your general practitioner or family doctor and take a general blood test. If the diagnosis is already known, it is necessary to be treated by a hematologist or oncohematologist. Additionally, the patient is consulted by a neurologist, cardiologist, gastroenterologist, ENT doctor (for nosebleeds), proctologist or surgeon (for hemorrhoidal bleeding), and gynecologist (for heavy menstruation or other uterine bleeding).