I-necrolic neutropenia yisimo esizuzwe njengefa lapho i-neutrophil count (i-white cell cell elwa nokutheleleka kwebhaktheriya) iba phansi kakhulu (ngokuvamile ngaphansi kwamangqamuzana angu-500 / mL) emjikelezweni cishe cishe njalo ezinsukwini ezingu-21. Ngokuvamile kubonisa ngonyaka wokuqala wokuphila. Imijikelezo iyancipha ngokuguga futhi ingadlulela kwezinye iziguli ezindala.
Ziyini Izimpawu?
Uma inani le-neutrophil livamile, azikho izimpawu.
Izimpawu zivame ukungena ngemuva kwe- neutropenia (inani elincane le-neutrophil) elisho ukuthi inani le-neutrophil selivele liphansi kakhulu ezinsukwini ezimbalwa ngaphambi kokuthuthukiswa kwezimpawu. Ephikisana nezinye izinhlobo zokuzalwa zesifo se-neutropenia (i-neutropenia ebanga kakhulu, iShwachman Diamond Syndrome , njll), ukukhubazeka kokuzalwa akubonwanga. Izimpawu zihlanganisa:
- I-Aphthous ulcers (izilonda emlonyeni)
- Ukuvuvukala okunamandla (pharyngitis)
- I-Gum ukuvuvukala (gingivitis)
- Izifo zesikhumba
- Fever
Ubani Osesengozini?
I-necropic ne-cyclic isifo sokuzala esithinta inhliziyo ukuthi umuntu uzalwa ngesimo. Idluliselwa emindenini ngendlela ehamba phambili ye-autosomal okusho ukuthi umzali oyedwa kufanele athintshwe ukuze adlulisele ezinganeni zabo. Akuwona wonke amalunga omndeni angathinteka ngokufanayo futhi amanye angase angabi nawo izimpawu.
Utholakala kanjani?
I-neutropenia ye-Cyclic ingaba inselele ukuxilonga njengoba i-neutropenia enamandla iphela izinsuku ezintathu kuya kwezi-6 phakathi nomjikelezo ngamunye.
Phakathi kwale mijikelezo, izibalo ze-neutrophil zivamile. Izifo zomlomo ezivamile kanye nomkhuhlane njalo ezinsukwini ezingu-21 kuya kwezingu-28 kufanele ziphakamise ukusola nge-neutropenia ye-cyclic. Ukuze ubambe umjikelezo we-neutropenia eqinile, ukugcwaliswa kwegazi okuphelele (CBC) kwenziwa izikhathi ezimbili kuya kwezi-3 ngesonto amasonto ayisithupha kuya kwangu-8.
Ngaphandle kwe-neutropenia enamandla, kungaba khona ukwehla kwamaseli obomvu abomvu (reticulocytopenia) kanye / noma amaplatelets (thrombocytopenia).
Inani le- monocyte (elinye uhlobo lensimbi yegazi elimhlophe) livame ukwanda ngesikhathi se-neutropenia eqinile.
Uma ngabe i-neutropenia ye-cyclic isolwa ngokususelwa ekubalweni kwegazi, ukuhlolwa kofuzo kufanele kuthunyelwe ukuze kubhekane nezinguquko ku-ELANE gene (ku-chromosome 19). Iziguli ezingu-90 - 100% ezine-neutropenia ye-cyclic zine-ELANE ishintsho. Ukuguqulwa kwesimo se-ELANE gene kuhlotshaniswa ne-neutropenia ye-cyclic kanye ne-neutropenia ebanga kakhulu. Njengoba kunikezwe isethulo semitholampilo kanye nokuhlolwa kofuzo lwe-genetic, i-bone marrow biopsy ayidingekile kepha kuvame ukuqhutshwa ngesikhathi sokusebenza kwe-neutropenia.
Yiziphi izinketho zokwelashwa?
Nakuba i-neutropenia ye-cyclic ibhekwa njengesimo esibucayi, ukufa okubangelwa ukutheleleka okubi kakhulu kuye kwenzeka. Ukwelashwa kuhloselwe ukuvimbela kanye / noma ukuphatha izifo.
- I-Granulocyte Colony-stimulating Factor (G-CSF, ebizwa ngokuthi i-filgrastim): I-G-CSF ivuselela umongo we-bone ukukhiqiza i-neutrophils engaphezulu. Isetshenziselwa ukuvimbela inani le-neutrophil ekungeneni ngaphansi kwezingu-500 amaseli / mL. I-G-CSF iye yaboniswa ukunciphisa ubukhulu be-neutropenia futhi yehlisa inani lezifo. I-G-CSF ilawulwa ngaphansi komzimba (nje ngaphansi kwesikhumba) njalo ezinsukwini ezingu-1 - 2. Ezinye iziguli zingakwazi ukuyeka i-G-CSF njengomuntu omdala ngoba ngezinye izikhathi i-neutropenia ithola amandla kakhulu ngobudala.
- Ukunakekelwa kwamazinyo okuvimbelayo: Ngenxa yokuthi eziningi zezifo zenzeka emlonyeni, kubalulekile ukulondoloza inhlanzeko yomlomo. I-antiwascterial mouthwashes inganconywa.
- Ukuhlolwa komkhuhlane: Ngenxa yokuthi iziguli ezine-neutropenia ye-cyclic zingahlakulela izifo ezinamandla ze-bacteria, kubalulekile ukuthi iziqephu ze-fever zihlolwe ngokucophelela. Ngezinye izikhathi, lezi ziqephu zizodinga ukunakekelwa esibhedlela ngama-antibiotics (intravenous (IV) kuze kufike ukutheleleka okungathí sina.