Ukuqonda ifomu elijwayelekile le-Anemia
Isifo se-cold agglutinin (i-CAD) uhlobo olunqamulelayo lwe- autoimmune i-hemolytic anemia-i- anemia eqala lapho amasosha omzimba wakho ehlaselwa futhi ebhubhisa amangqamuzana akho abomvu egazi. Isizathu esivame kakhulu se-AIHA senziwa ngenxa ye-autoantibody efudumele. Lokhu kusho ukuthi i-antibody igxila esitokisini segazi elibomvu ekushiseni okufudumele (umzimba). Njengoba igama liphakamisa, i-CAD ivela emkhakheni we-autoantibody obandayo, okusho ukuthi i-antibody ihlanganisa lapho iseli elibomvu legazi livuleka emazingeni okushisa okushisa, ngokuvamile ezandleni, ezinyaweni nasemakhaleni.
Lezi zinselo zomzimba zibangela ukuthi amangqamuzana akho abomvu egazi abambe ndawonye, okuthiwa i-agglutination. I-CAD ivela kaningi kakhulu kwabesifazane, ikakhulukazi esikhathini esidala.
Yiziphi Izimpawu ze-CAD?
- Ukukhathala noma ubuthakathaka
- Ukuphefumula, ikakhulukazi ngomsebenzi
- I-Acrocyanosis: ukuchithwa okubomvu kweminwe, izinzwane, impumulo, noma izindlebe. Lokhu kukhishwa kwemvelo kuyanyamalala lapho indawo isha. Lokhu kungahlanganiswa nobuhlungu. Akufanele kudidaniswe nesenzo sikaRaynaud .
- I-Rash: I-CAD ingabangela i-liveo reticularis, ukuthuthukiswa kwe-purple, i-lace-like-burn. Ngezinye izikhathi lokhu kubizwa ngokuthi isikhumba semoto.
Yini eyenza i-CAD?
- Idiopathic: asikho isizathu esibonakalayo
- Ukwelashwa: Izimbangela ezimbili ezivame kakhulu yi-mycoplasma pneumonia (ukutheleleka kokuphefumula) ne-Epstein-Barr Virus (i-EBV, igciwane elibangela i-mononucleosis). Kungabuye kubangelwe ezinye izifo ezibangelwa amagciwane, njenge-cytomegalovirus (CMV), isishukela, imifino noma i-rubella. Lezi zimo ze-CAD zizimele futhi zixazululwe phakathi kwamasonto amathathu kuya kwamathathu.
- I-lymphocytic leukemia engapheliyo
- I-Lymphoma: umdlavuza we-lymph nodes
I-CAD ihlolwe kanjani?
Uma i-anemia ilula, ingase itholakale ngesigameko ngokubala okuphelele kwegazi (i-CBC) ekhishwe ezinye izizathu. Ngaphezu kwe-anemia, i-CBC ingabonisa futhi i-macrocytosis, usayizi okhulisiwe wamaseli abomvu obomvu. Amangqamuzana egazi abomvu awayikho amakhulu, kodwa lapho amangqamuzana abomvu ehlangene ndawonye, umshini uwufunda njengelinye lamaseli amakhulu abomvu amakhulu.
Ukubuyekezwa kwe-blood pipeline smear (i-microscope slide yegazi) kungasiza ekunqumeni ukuthi ukuxhunyelelwa (okunamathela ndawonye) amaseli akhona. Njengamanye ama-anemia e-hemolytic, inani le-reticulocyte (iseli elibomvu elisha elibomvu) liphakanyisiwe njengoba umongo wethambo uzama ukufaka esikhundleni samaseli abomvu egazi abhubhile.
Ngenxa yokuthi i-CAD i-anemia ye-immune hemolytic, ukuhlolwa kwe-antiglobulin eqondile (i-DAT, noma ukuhlolwa okuqondile kweComber) kuyoba nomphumela omuhle, kubonisa ukuba khona kwama-antibodies omzimba wegazi obomvu. Kukhona ukuhlolwa okukhethekile okubheka ukutholakala kwama-agglutinins abandayo ukuqinisekisa ukuxilongwa.
Ngenxa yokuthi iningi le-CAD lisezingeni elilodwa kwenye inkinga, ukuhlolwa okwengeziwe kungathunyelwa ukunquma imbangela, ukuze iphathwe ngendlela efanele.
Yiziphi Izindlela Zokwelashwa Kwamafo Ebandayo Agglutinin?
Uma i-anemia ilula, akukho ukwelashwa okuqondile okudingekayo. Uma i-anemia yakho inzima futhi / noma unesifo esivela ku-anemia (isilinganiso senhliziyo esheshayo, ukukhathala, isizungu) cishe uzodinga ukumpontshelwa kwegazi elibomvu. Ngenxa yokuthi ukumpontshelwa igazi akuqedi i-autoantibody ebandayo, ukumpontshelwa kudinga ukunikezwa ngomfudumala, ukuze i-antibody ingabambeli kumaseli abomvu egazi.
Ingxenye ebaluleke kakhulu yokwelashwa kwe-CAD iwukugwema amazinga okushisa abandayo. Lokhu kuzwakala kulula kunalokho okukhona empilweni yangempela. Lokhu kusho ukuthi abantu abahluphekayo nge-CAD bavame ukugqoka izigqoko, amaglavu, namasokisi ngisho nasesimo sezulu esifudumele, njengoba ungase ubonakale emakamelweni abandayo noma ezindaweni. Ngaphezu kokugqoka okufudumele, ukuphuza utshwala obubandayo, noma ukugcoba izingxenye zomzimba emanzini abandayo kufanele kugwenywe.
I-Rituximab iyi-intraveous (IV) imithi esiza ukubhubhisa amaseli egazi amhlophe akhiqiza ama-antibodies ngokumelene namaseli abomvu abomvu, okuthiwa yi-B-cells. Ithemba ukuthi uma ama-B-cells akho avuselela, ngeke asakwazi ukwenza i-antibody.
Lokhu kuvame ukusetshenziselwa iziguli ezinezifo ezinzima.
Imithi efana ne-steroids kanye ne-immunoglobulin (IVIG) enomzimba, esetshenziselwa ezinye izifo zegazi ze-immune ingasebenzi kahle ku-CAD. I-Splenectomy (ukususwa kokuhlinzwa kwe-spleen) kungaba yindlela yokwelapha ephumelelayo kakhulu ye-autoimmune i-hemolytic anemia, kodwa ku-CAD iningi legazi elibomvu selibhubhiso livela esibindi, okwenza lingasebenzi.