Ukubukeza Izimpawu, Ukuxilongwa, Nokunakekelwa
Incazelo
I-immune thrombocytopenia (i-ITP), eyayibizwa nge-idiopathic thrombocytopenic purpura, isimo lapho isimiso somzimba wakho somzimba sihlasela khona futhi sibhubhisa amaplatelet akho okubangela ukubalwa kwamaplatelet aphansi ( thrombocytopenia ). Ama-platelets adingekayo ukuze agcoke igazi futhi uma ungenayo ngokwanele, ungase uphethwe igazi.
Izimpawu ze-ITP
Izimpawu ze-ITP zihlobene nengozi eyengeziwe yokwelapha ngenxa yobalo bakho beplatelet ephansi.
Kodwa-ke, abantu abaningi abane-ITP abanakho izimpawu.
I-Nosebleeds
Ukuhlwitha kusuka ezinsini
Igazi emcintini noma esitokisini
Ukweqa ngokweqile kokuphuma esikhathini esibizwa ngokuthi i- menorrhagia
I-Petechiae - amachashazi amancane amasha afana nokugqwala kodwa empeleni isilinganiso esincane sokuphuma ngaphansi kwesikhumba
Ukwehla okulula - izivunguvungu zingase zibe ezinkulu futhi zikwazi ukuzwa ngaphansi kwesikhumba
I-blood blisters ngaphakathi emlonyeni obizwa ngokuthi i-purpura
Izimbangela ze-ITP
Ngokuvamile, isibalo sakho seplatelet sehla ku-ITP ngoba umzimba wakho wenza ama-antibodies anamathisele kuma-plateslet futhi abatshengise ukubhujiswa. Lapho la mapleletethi egeleza nge-spleen (isitho esiswini esihlunga igazi), siyaqaphela lezi zinselo futhi zibhubhise amaplatelets. Futhi ukukhiqizwa kwamaplatelets kungancishiswa. I-ITP ivame ukuvela emva kwesinye isenzakalo esikhuthazayo, ngezinye izikhathi udokotela wakho angeke akwazi ukunquma ukuthi lo mcimbi ubani.
Amagciwane: Ezinganeni, i-ITP ivame ukubangelwa ukutheleleka ngegciwane. Ukutheleleka kwesandulela ngculaza ngokuvamile kwenzeka amasonto ambalwa ngaphambi kokuthuthukiswa kwe-ITP. Ngesikhathi isimiso somzimba sokuzivikela sisenza izifo ezilwa namagciwane ukulwa nokutheleleka kwegciwane ngengozi futhi kwenza izifo ezithathelwanayo ezinamathelethi.
Ukugonywa: I- ITP ihlotshaniswe nokuphathwa kwe-MMR (imishanguzo, imisipha, rubella). Ngokuvamile kubonakala kungakapheli amasonto ayisithupha okuthola umgomo. Kubalulekile ukuqaphela ukuthi lokhu kuyisenzakalo esingavamile esinamacala angu-2.6 kuwo wonke ama-MMR ayi-100,000. Lo mngcipheko uncane kunengozi yokuthuthukisa i-ITP uma unesifo sobuthakathaka noma u-rubella. Ukuphuma kwegazi okuvamile kungavamile kulezi zimo futhi abantu abangaphezu kwezingu-90 bazoba nesinqumo se-ITP ezinyangeni ezingu-6.
I-autoimmune isifo: I- ITP ibhekwa njengesiyaluyalu se-autoimmune futhi ihlotshaniswa nezinye izifo ezizimele njenge-lupus ne-rheumatoid arthritis. I-ITP ingaba isethulo sokuqala salinye yalezi zimo zezokwelapha.
Ukuxilongwa kwe-ITP
Ngokufanayo nezinye izifo zegazi ezifana ne- anemia ne- neutropenia , i-ITP ibonakala ngokubala kwegazi eliphelele (i-CBC). Asikho ukuhlolwa okuhlolisisa kwe-ITP. Kuxilongwa ukuxoshwa, okusho ukuthi ezinye izimbangela zikhishwe ngaphandle. Ngokuvamile, inani leplatelet kuphela liyehla ku-ITP; i-white cell cell count kanye ne-hemoglobin zivamile. Umhlinzeki wakho wokunakekelwa kwezempilo angase abe nama-plateslet ahlolwe ngaphansi kwe-microscope (ebizwa ngokuthi i-peripheral blood smear) ukuqinisekisa ukuthi amapleletthi ancipha ngenombolo kodwa avele evamile. Phakathi nesikhuthazo, ungase ube nezinye ukuhlolwa ukulawula umdlavuza noma ezinye izizathu zokubalwa kweplatelet ephansi, kodwa lokhu akudingeki ngaso sonke isikhathi. Uma i-ITP yakho icatshangwa ukuthi iyesibili kwisifo esizimele, kungadingeka ukuthi uhlole ngokuqondile lokhu.
Ukwelashwa kwe-ITP
Njengamanje, ukwelashwa kwe-ITP kuncike ekuboneni kwezimpawu zokuphuza kunokuba kube nesibalo esithile seplatelet. Umgomo wezokwelapha ukuyeka ukuphuma noma ukuletha inani leplatelet kuze kube "uhla oluphephile".
Yize ngokungeyona "ukwelapha", abantu abane-ITP kufanele bagweme ukuthatha imithi ye-aspirin noma imithi e-ibuprofen njengoba le mithi yehlisa umsebenzi weplatelets.
Ukuqaphela: Uma ungenayo izimpawu zokuphuza okwamanje, udokotela wakho angakhetha ukukubuka ngaphandle kokunikeza imithi.
I-Steroids: I- steroids efana ne-methylprednisolone noma i-prednisone yiyona imithi ejwayelekile esetshenziselwa ukuphatha i-ITP emhlabeni wonke. I-Steroids inciphisa ukubhujiswa kwamaplatelet ku-spleen. I-Steroids iyasebenza kakhulu kodwa kungathatha isikhathi esingaphezu kweviki ukwandisa isibalo sakho seplatelet.
I-IVIG: I-immune globulin (i-IVIG) engenamaphilisi iyindlela yokwelapha evamile ye-lTP. Ngokujwayelekile isetshenziselwa iziguli ezinegazi elidinga ukunyuka okusheshayo ekubaleni kweplatelet. Ilawulwa njenge-intraveous (IV) ukumnika amahora amaningana.
WinRho: WinRho imithi ye-IV engasetshenziselwa ukwandisa isibalo seplatelet kubantu abanezinhlobo ezithile zegazi. Kuyinto ukumnika okusheshayo kune-IVIG.
Ukumpontshelwa kweplatelet: Ukumpontshelwa kweplatelet akuzona njalo okuwusizo kubantu abane-ITP kodwa kungasetshenziswa ezimweni ezithile njengokungathi udinga ukusebenza.
Uma i-ITP yakho iqhubeka futhi ingaphenduli kokwelapha kokuqala udokotela angase ancome ezinye izindlela zokwelashwa ezifana nalezi:
I-Splenectomy : Ku-ITP ama-platelets abhujiswe esitezini. Ngokususa i-spleen, ukulinda kokuphila kwama platelet kungandiswa. Izinzuzo nezingozi kufanele zilinganiswe ngaphambi kokuthatha isinqumo sokususa ipeni.
I-Rituximab : I- Rituximab imithi ebizwa ngokuthi i-antioclonal antibody. Le mithi isiza ukubhubhisa amangqamuzana amhlophe egazi okhiqiza ama-antibodies ngokumelene namaplatelet, abizwa ngokuthi ama-B-cells. Ithemba ukuthi uma umzimba wakho ukhiqiza ama-B-cells amasha, ngeke asakwazi ukwenza i-antibody ngokumelene ne-platelet.
I-thrombopoietin agonists: Ezinye zezokwelapha ezintsha kakhulu zi-thrombopoietin (TPO) ze-agonists. Le mithi i-eltrombopag (ngomlomo) noma i-romiplostim (engaphansi); zikhuthaza umnkantsha wakho ukuba wenze amaplatelets amaningi.
Ukungezwani kwezingane kanye nabantu abadala
Kubalulekile ukuthi uqaphele ukuthi umlando wemvelo we-ITP uvame ukuhluka kubantwana ngokubambisana nabantu abadala. Izingane ezingaphezu kuka-80% ezihlolwe nge-ITP zizoba nesinqumo esiphelele. Intsha kanye nabantu abadala bayakwazi kakhulu ukuthuthukisa i-ITP engapheli okuba yinkinga yezempilo yokwelashwa okungapheli noma engadingi ukwelashwa.
> Umthombo:
> CE Neunert, uDL Yee. Ukuphazamiseka kwamaPlatelet. Ku: CD Rudolph, AM Rudolph, GE Lister, LR First and AA Gershon eds. I-Rudolph's Pediatrics . 22nd. ENew York: McGraw Hill Medical, ngo-2011.