Ngesikhathi ukuhlolwa kwengane yakho enonyaka owodwa ubudala kuyinto engavamile ukuba udokotela wezingane zakho athumele inani eliphelele legazi (CBC) . Le CBC isetshenziselwa ukuhlola ukutholakala kwesifo se- iron anemia njengengane yokuguquka kusuka ebisi lwebele noma ifomula kuze kube nobisi lonke. Ungase umangale lapho ihhovisi lezingane zezingane libiza ukuba likwazise ukuthi ingane yakho ayinayo i-anemic kodwa ukuthi inani labo elimhlophe legazi, ikakhulukazi amangqamuzana e-bacterium ebizwa nge-neutrophils, aphansi.
Kuleli phuzu, ungase uzizwe unesabekile futhi uzibuze ukuthi yini engalungile.
Ngenhlanhla, isizathu esivame kakhulu se- neutropenia (isibalo esincane se-neutrophil) ezinganeni yisifo sofuba. Phakathi nokutheleleka kwegciwane, ukukhiqizwa kwe-neutrophils kuncishisiwe, okungabangela i-neutropenia. Uma ukutheleleka kuhluma, inani le-neutrophil libuyela emuva evamile, ngakho-ke udokotela wezingane angase ancoma ukuthi abuyele i-CBC ngesonto noma amabili. Uma i-neutropenia iphikelela, ingane yakho ingathunyelwa ku-hematologist ukucacisa imbangela ye-neutropenia.
Yini i-Neimropenia ye-Autoimmune Autoimmune?
I-autoimmune neutropenia yengane ingase futhi ibizwa ngokuthi i-neutropenia engapheliyo yengane yobuntwana. Lesi simo sifana ne- immune thrombocytopenia (i-ITP) ne- autoimmune i-hemolytic anemia (AIHA) . Naphezu kokuthi umongo we-bone wenza i-neutrophils evamile, umzimba ngokungalungile wenza izifo ze-antibodies zibe yi-neutrophils ezibaphawule ekubhujisweni, okuholela e-neutropenia.
I-autoimmune neutropenia yezingane ngokuvamile iveza ezinganeni ezinyangeni ezingu-6 kuya kwezingu-15 kodwa zingenzeka kunoma yisiphi isikhathi, ngisho nokuba umuntu omdala. I-neutropenia ngokuzenzakalelayo ehlangene ne-ITP noma i-AI ibizwa nge- Evans Syndrome .
Izimpawu
Iningi lezingane ezine-neutropenia e-autoimmune azikho izimpawu. Lokhu kungenxa yokuthi, naphezu kokubala okuncane okuncane kwe-neutrophil, izifo ezinzima azivamile.
I-neutropenia ingase itholakale ku-CBC itholakale encane ibe yindlebe noma ukutheleleka kokuphefumula. Ezinye izingane zingase zizwe izilonda zomlomo noma izifo zesikhumba.
Ukuxilongwa
Njengezinye izinhlobo ze-neutropenia, ukuhlolwa kokuqala kokuxilongwa yi-CBC. Inani le-neutrophil eliphelele (i-ANC) lingaphansi kwamangqamuzana angu-1000 nge-microliter ngayinye futhi ingaba ngaphansi kuka-500. Ngokujwayelekile, inani le-hemoglobin kanye ne-plateslet livamile. I-blood smear yegazi, ukuhlolwa kwamaseli egazi ngaphansi kwe-microscope, kungase kukhishwe. Nakuba inani le-neutrophils liphansi, linokubonakala okujwayelekile.
Okulandelayo, udokotela wakho cishe uzothola ama-CBC kabili ngesonto okungenani amaviki ayisithupha ukuze aqinisekise ukuthi ingane yakho ayinayo i-neutropenia yama-cyclic (isimo lapho i-neutrophils iphansi khona izinsuku ezimbalwa zonke izinsuku ezingu-21).
Udokotela wakho angathumela ukuhlolwa ukuze anqume ukuthi kukhona yini ama-antibodies kuma-neutrophils, ewabeka ekubhujisweni. Uma lokhu kuhlolwa kunembile, kuqinisekisa ukuxilongwa. Ngeshwa, uma ukuhlolwa kungalungile akukhiphi i-autoimmune neutropenia. Kwezinye iziguli, amasosha omzimba we-anti-neutrophil awaqapheli. Kulezi zimo, uma ubudala nesethulo kufana nesithombe se-neutropenia ye-autoimmune, ukuxilongwa kuthathwa njengokucatshangelwayo.
Ezimweni ezingavamile, ukuhlolwa komnkantsha wamathambo kungadingeka ukulawula ezinye izimbangela ze-neutropenia. Lokhu kwenzeka kakhulu ezinganeni ezingenayo isethulo kanye nezifo ezingafani nesithombe esivamile sezingane ezihamba nge-autoimmune neutropenia.
Ukwelapha
Ayikho ukwelashwa okuqondile kwe-autoimmune neutropenia yobuntwana. Ama-anti-neutrophil antibodies azophela ngokuzenzakalelayo futhi inani le-neutrophil lizobuyela ejwayelekile. Ukutakula ngokuzenzekelayo kwenzeka ngo-5 ubudala, ne-neutropenia ehlala ezinyangeni ezingu-20 ezijwayelekile.
Ngenxa yokuthi i-neutropenia yandisa ingozi yokutheleleka, yonke imfiva idinga ukuhlolwa kwezempilo.
Lokhu ngokuvamile kuqukethe i-CBC, isiko legazi (ukubeka igazi emabhodleleni eglasi ukuze ubheke amabhaktheriya), futhi okungenani umthamo owodwa wama-antibiotic. Uma i-ANC ingaphansi kwamangqamuzana angama-500 / mL, ingane yakho ingeniswa esibhedlela kuma-antibiotic e-IV ukuze ibone. Uma ingane yakho ibukeka kahle futhi i-ANC ingaphezu kuka-1000 cell / mL, cishe uzokhishwa ekhaya ngokulandela ukulandelwa kweziguli.
Imithi esetshenziselwa ezinye izifo ze-immune (i-ITP, i-AIHA) njenge-steroids kanye ne-immune globulin (IVIG) engenamaphesenti awaphumelelanga ne-neutropenia engenawo umuntu. Ngezinye izikhathi i-filgrastim (G-CSF) ingasetshenziswa ngesikhathi sokutheleleka okusebenzayo ukukhuthaza ukukhululwa kwe-neutrophils emsakeni wamathambo kuze kuqhutshekwe igazi.
Imithombo
Coates TD. I-neutropenia ye-immune. Ku-UpToDate, i-Post TW (Ed), UpToDate, i-Waltham, MA.