So wo mogya mu nkwammoaa kɔkɔɔ dɔɔso? Momma yɛnka Thrombocytosis ho asɛm!

So wɔahu nso sɛ mogya mu nkwammoaa a ɛdɔɔso wɔ wo mogya mu? Anaasɛ obi a wunim no wɔ saa tebea yi? Ɛyɛ ade a ɛfata sɛ wobɛte ehu nka kakra bere a wote biribi a ɛte sɛɛ no. Nanso mma ɛnhaw wo, ɛnnɛ yɛbɛka saa tebea yi a wɔfrɛ no Thrombocytosis ho asɛm wɔ ɔkwan tiawa bi so a wubetumi ate ase.

Dɛn ne thrombocytosis? Sɛ yɛbɛka no tiawa a...

Sɛ yɛbɛka no tiawa a, thrombocytosis yɛ bere a mogya mu nkwammoaa a ɛdɔɔso dodo wɔ wo mogya mu no. Afei ebia worebisa sɛ, “Dɛn ne mogya mu nkwammoaa a ɛma mogya tu?” Ɛno yɛ asɛmmisa a ɛho hia paa!

Nkwammoaa a wɔfrɛ no platelets yɛ nkwammoaa ketewaa bi a ɛwɔ yɛn mogya mu. Wɔn adwuma titiriw ne sɛ wobegyae mogya a ɛretu bere a mogya retu, te sɛ bere a kuru wɔ hɔ no. Wɔyɛ wɔn ade te sɛ abura ketewaa bi.

Nanso sɛ mogya nkwammoaa dodow kɔ soro dodo a, dɛn na ɛba? Wo mogya betumi ayɛ den na ayɛ nnam. Wɔ tebea horow bi a emu yɛ den mu no, mogya mu nkwammoaa a ɛboro so yi betumi ama mogya a ɛyɛ hu atɔ mogya ntini no mu. Eyi betumi ama asiane a ɛwɔ hɔ sɛ obi benya tebea horow te sɛ ɔyare a ɛma obi hwe ase anaa komayare no ayɛ kɛse .

Nanso, ɛnyɛ Thrombocytosis nsɛm nyinaa na asiane wom pɛpɛɛpɛ. Sɛnea tebea no mu yɛ den, ne sɛ ebia wuhia ayaresa anaasɛ wunhia no gyina nea ɛde ba no so.

Thrombocytosis ahorow atitiriw abien na ɛwɔ hɔ:

Yiw, nnuruyɛfo ahu tebea yi ahorow atitiriw abien. Momma yɛnka saa asɛm no ho asɛm kakra.

1. Thrombocythemia a Ɛho Hia (ET) anaasɛ Thrombocytosis a Ɛho Hia

Eyi yɛ mogya mu yare a ɛntaa nsi. Ɛba bere a wo nnompe mu ntini – mogya nkwammoaa adwumayɛbea a ɛwɔ wo nnompe mu – ma mogya nkwammoaa pii ba no. Susuw ho hwɛ, mogya nkwammoaa a ɛwɔ yɛn nipadua mu no mu dodow no ara yɛ nnompe mu ntini yi. Obi a ɔwɔ thrombocythemia a ɛho hia no nya mogya nkwammoaa a ɛdɔɔso wɔ ɔkwan a ɛnteɛ so esiane sintɔ bi a ɛwɔ mogya nkwammoaa a wɔyɛ yi mu nti.

Wobu tebea yi a wɔfrɛ no ET (Essential Thrombocythemia) , sɛ ɛyɛ yare a abu so sen biara wɔ mogya kuw a wɔfrɛ no Myeloproliferative Neoplasm (MPN) .

2. Thrombocytosis a ɛyɛ adwuma anaa Thrombocytosis a ɛto so abien

Eyi ne Thrombocytosis a ɛtaa ba. Eyi ne bere a wo nipadua no yɛ mogya nkwammoaa pii de bua tebea foforo, ɔyare mmoawa, opira, oprehyɛn, anaasɛ woyi akyi berɛmo no. Sɛ yɛbɛka no tiawa a, wo nipadua no yɛ n’ade wɔ biribi foforo ho na ɛma mogya nkwammoaa a ɛwɔ mu no kɔ soro. WeiMpɛn pii no, reactive thrombocytosis yɛ bere tiaa mu de, a ɛkyerɛ sɛ sɛ wosiesie nea ɛde ba no pɛ a, mogya nkwammoaa dodow no san kɔ sɛnea na ɛte kan no.

Hena na onya thrombocytosis?

Wɔtaa hu saa tebea yi wɔ nnipa a wɔadi boro mfe 60. Afei nso, wɔbɔ amanneɛ sɛ wohu ɔkwan bi a wɔfrɛ no Essential Thrombocythemia (ET) wɔ mmea mu mmɔho abien sen mmarima.

Dɛn ne nneɛma a ɛde thrombocytosis ba?

Nea enti a nneɛma abien a yɛadi kan aka ho asɛm no nso yɛ soronko.

Nneɛma a Ɛde Thrombocythemia a Ɛho Hia (ET) Ba .

Essential Thrombocythemia (ET) yɛ awosu mu tebea a wonya. Ɛnyɛ biribi a wɔde awo wo. Ɛnam nsakrae, anaa nkwaadɔm mu nsakrae a ɛba awosu mu nkwaadɔm bi a ɛka ho ma mogya nkwammoaa a ɛma mogya tu no mu na ɛba. Eyi ma wo nnompe mu ntini no yɛ mogya nkwammoaa pii dodo.

Nnipa a wɔwɔ Essential Thrombocythemia (ET) no mu bɛboro fã wɔ nkwaadɔm mu nsakrae wɔ JAK2 awosu mu abɔde mu. Nsakrae a ɛba CALR anaa MPL awosu mu nkwaadɔm mu nso abu so.

Nyansahufo ntumi nhu nea ɛde awosu mu nkwaadɔm mu nsakrae yi ba ankasa, nanso nhwehwɛmu a wɔyɛ wɔ ho no kɔ so.

Nneɛma a ɛde Reactive Thrombocytosis ba

Saa ɔkwan yi ba efisɛ wo nipadua no yɛ mogya nkwammoaa pii de bua tebea horow. Anaasɛ, ɛtɔ mmere bi a, ebetumi aba nso esiane sɛ mogya nkwammoaa dedaw boaboa ano mmom sen sɛ ɛbɛsɛe wɔ ɔkwan a ɛfata so nti.

Nneɛma bi a ebetumi ama Reactive Thrombocytosis aba ni :

• Monemia , titiriw mogya a ɛtɔ kɔ nipadua mu a dade nnim.
• Mogya mu nyarewa afoforo.
• Kokoram ahorow bi .
• Nyarewa, te sɛ ahurututu mu yare .
• Ɔhyew tebea – tebea horow a ɛde ɔfe ba nipadua no mu, te sɛ ntini mu yare.
• Opira .
• Asaabo a entumi nyɛ adwuma yiye .
• Nnuru bi.
• Oprehyɛn, titiriw yafunu mu oprehyɛn.
• Spleen a woyi fi hɔ.
• Vitamin B12 a enni nipadua no mu a wɔsa.

Nneɛma kakraa bi a ɛtaa de ba nkutoo na ɛka saa din yi ho. Nneɛma afoforo pii betumi de Reactive Thrombocytosis aba .

Dɛn ne thrombocytosis ho sɛnkyerɛnne ahorow?

Mpɛn pii no, nnipa a mogya mu nkwammoaa a ɛdɔɔso no nhu sɛnkyerɛnne biara, anyɛ yiye koraa no, ɛnyɛ nea edi kan. Sɛ wowɔ Reactive Thrombocytosis , a, ebia wubehu aduruyɛ mu tebea a ɛde bae no ho sɛnkyerɛnne.

Nanso, sɛ yare no ho sɛnkyerɛnne ahorow ba a, ɛtaa fa mogya a ɛba wo nipadua mu a ɛnyɛ ne kwan so ne mogya a ɛtwetwe wɔ wo nipadua mu no ho. Ebia wubehu sɛnkyerɛnne ahorow te sɛ:

• Tipaeɛ .
• Ɛnyɛ den sɛ ɛbɛpirapira.
• Sɛ wote nka sɛ wayɛ mmerɛw, n’adwene mu yɛ no naa, anaasɛ ne ti yɛ hare.
• Mogya a ɛtɔ fi hwene, ano, ne anom.
• Mogya a ɛtɔ wɔ yafunu anaa dwensɔtwaa mu.

Nnipa binom a wɔwɔ Essential Thrombocythemia (ET) betumi anya tebea bi a wɔfrɛ no Erythromelalgia . Eyi ma nsa ne anan yɛ yaw, hohoro, na ɛyɛ kɔkɔɔ. Ebia wɔn nsa ne wɔn nan nso ho bɛtɔ wɔn na wɔn ho ayɛ wɔn yaw.

Wɔ tebea horow a emu yɛ den mu no, thrombocytosis betumi ama mogya atɔ yafunu no mu wɔ ɔkwan a ɛnteɛ so (e.g., Budd-Chari syndrome ) na ama asiane a ɛwɔ hɔ sɛ obi benya akisikuru anaa komayare no ayɛ kɛse .

Ɔkwan bɛn so na wohu thrombocytosis?

Esiane sɛ thrombocytosis ntaa mma yare no ho sɛnkyerɛnne mma nti, ade a edi kan a wubehu ne sɛ mogya mu nhwehwɛmu a wɔyɛ no daa (e.g., Complete Blood Count – CBC ) kyerɛ sɛ mogya nkwammoaa dodow akɔ soro a.

Wɔkyerɛ thrombocytosis ase sɛ mogya nkwammoaa bɛboro 450,000 na ɛwɔ mogya microliter biara mu. Sɛ mogya mu nkwammoaa a ɛwɔ wo mogya mu no dɔɔso a, ɛda adi sɛ wo duruyɛfo bɛhyɛ sɛ wɔsan nyɛ wo mogya mu nhwehwɛmu wɔ adapɛn kakraa bi akyi de hwɛ sɛ dodow no da so ara yɛ kɛse anaa. Mpɛn pii no, mogya nkwammoaa dodow a ɛkɔ soro pɛnkoro na afei ɛsan ba sɛnea na ɛte kan no nyɛ ɔhaw. Nanso, dodow a ɛkɔ soro bere nyinaa no betumi akyerɛ sɛ obi wɔ aduruyɛ mu tebea bi a ɛhyɛ ase.

Wɔ reactive thrombocytosis fam no, sɛ wohu tebea a ɛde bae (e.g., iron deficiency anemia , kokoram, ɔyare mmoawa) a, ebetumi aboa nnuruyɛfo ma wɔahu na wɔadi ho dwuma. Nanso, sɛ oduruyɛfo no ntumi nhu ade a ɛto so abien a ɛte saa a, wɔbɛyɛ nhwehwɛmu foforo ahwɛ sɛ wowɔ Essential Thrombocythemia (ET) anaa.

Ebia sɔhwɛ ahorow yi bi ne:

• Mogya a wɔde gu nipadua no akyi:Eyi hwɛ sɛ mogya mu nkwammoaa a ɛwɔ wo mogya mu no te sɛ nea ɛnteɛ anaa.
• DNA/awosu mu nhwehwɛmu: Eyi betumi ahu awosu mu nsakrae te sɛ JAK2 , a ɛtaa ne ET (Essential Thrombocythemia) .
• Bone marrow biopsy: Eyi hwɛ wo nnompe mu ntini mu sɛ ebia nkwammoaa a ɛnyɛ ne kwan so wɔ hɔ anaa.

Ɔkwan bɛn so na wɔsa thrombocytosis?

Sɛ wunni yare no ho sɛnkyerɛnne biara a, ebia nea ehia ara ne sɛ wɔyɛ wo nhwehwɛmu daa.

Mpɛn pii no, enhia sɛ wɔsa reactive thrombocytosis (secondary thrombocytosis) yare. Mpɛn pii no, mogya nkwammoaa dodow san kɔ sɛnea na ɛte kan no bere a tebea a ɛde mogya nkwammoaa dodow a ɛkɔ soro bae (te sɛ opira, ɔyare mmoawa, anaa sɛnea wɔyɛɛ wɔn ade wɔ oprehyɛn ho) no ano aduru. Nanso, sɛ wowɔ sɛnkyerɛnne ahorow a, wo duruyɛfo no bɛsa nea ɛde ba no.

Sɛ wowɔ Essential Thrombocythemia (ET) na worehu sɛnkyerɛnne ahorow a, ebia wo duruyɛfo bɛkamfo ayaresa ahorow pii akyerɛ wo, te sɛ:

• Aspirin a ɛba fam a wobɛnom da biara: Wubetumi anom aspirin da biara na amma mogya antɔ. Mpɛn pii no, saa dodow a ɛba fam yi mma yafunu nyɛ yaw anaasɛ mogya ntu. Nanso, nnom aspirin daa a wo ne wo duruyɛfo nkasa.
• Nnuru a ɛma mogya nkwammoaa dodow so tew a wɔnom: Nnuru te sɛ Hydroxyurea (ahyɛnsode: Droxia®, Hydrea®, Siklos®, Mylocel®) ne Anagrelide (ahyɛnsode: Agrilyn®) brɛ mogya nkwammoaa a ɛba nnompe mu ntini mu no ase. Interferon alfa (ahyɛnsode: Multiferon®) mma mogya nkwammoaa a ɛnteɛ no ntumi nkyɛ na ɛnnɔɔso.
• Oprehyɛn a wobɛyɛ de ayi wo mogya mu nkwammoaa kɔkɔɔ: Sɛ wo mogya mu nkwammoaa kɔkɔɔ dodow dɔɔso araa ma asiane wom sɛ wubenya mogya a ɛtɔ a ɛde wo nkwa to asiane mu a, ebia wo duruyɛfo bɛkamfo ɔkwan bi a wɔfrɛ no plateletpheresis . Nea ɛka eyi ho ne sɛ wode afiri bi yi mogya mu nkwammoaa a ɛboro so no fi wo mogya mu. Nanso, wɔ thrombocytosis , nsɛm dodow no ara mu no, ɛho nhia sɛ mogya nkwammoaa a ɛma mogya tu no yɛ adwuma.

Nea ɛho hia: Mfi ase anaasɛ nnyae ayaresa yi mu biara a wunni aduruyɛfo afotu. Ɛsɛ sɛ wo ne wo duruyɛfo susuw biribiara ho na woyɛ no wɔ n’akwankyerɛ ase.

So wobetumi asa thrombocytosis koraa?

Thrombocythemia a Ɛho Hia (ET) .Mprempren wonni aduru biara a wɔde sa thrombocytopenia. Nanso, wo duruyɛfo betumi aboa wo ma woadi tebea no ho dwuma na ama asiane a ɛwɔ hɔ sɛ mogya bɛtɔ wo no so atew. Wɔ reactive thrombocytosis (a nneɛma a ɛto so abien na ɛde ba) fam no, mpɛn pii no mogya nkwammoaa mu nkwammoaa dodow san kɔ sɛnea na ɛte kan bere a wɔasa nea ɛde ba no.

So wobetumi asiw thrombocytosis ano?

Wontumi nsiw tebea horow pii a ɛde thrombocytosis ba ano, a Essential Thrombocythemia (ET) ka ho.

So thrombocytosis de nkwa to asiane mu?

Nkwammoaa mu nkwammoaa a ɛkɔ soro no nyɛ nea ɛde nkwa to asiane mu, nanso nsɛnnennen a ebetumi aba – te sɛ mogya a ɛtɔ anaa mogya a ɛtɔ kɛse – betumi ayɛ asiane.

Nneɛma a ɛde thrombocytosis ba dodow no ara yɛ bere tiaa mu de, na ɛntaa mma mogya mu ntini a ɛyɛ hu. Wɔ Essential Thrombocythemia (ET) mu no, asiane no dɔɔso kakra. Nanso, wo duruyɛfo bɛhwɛ wo yiye, akyerɛw wo nnuru a ɛho hia, na wayɛ nneɛma a ɛho hia na amma mogya a ɛbɛtɔ a asiane wom no. Enti mma ɛnhaw wo.

Dɛn ne obi a ɔwɔ thrombocytosis no anidaso?

Mpɛn pii no, reactive thrombocytosis gyae bere a wɔasa ɔhaw a ɛda adi no. Ɛwom sɛ ebia wo mogya nkwammoaa dodow bɛkɔ soro bere tiaa bi (na ebia bere tenten wɔ bere a wɔayi w’akyi berɛmo akyi) de, nanso mpɛn pii no, mogya mu nkwammoaa a ɛto so abien no mma mogya nkɔ soro wɔ ɔkwan a ɛnteɛ so.

Essential Thrombocythemia (ET) , anaasɛ thrombocytosis titiriw betumi ama mogya atɔ kɛse anaasɛ mogya a ɛbɛtɔ mu nsɛnnennen aba. Nnuru a wobɛnom na ama wo mogya mu nkwammoaa kɔkɔɔ dodow akɔ so ayɛ nea ɛfata no betumi aboa ma woasiw eyi ano. Nanso, bere a obi anya yare no mfe pii akyi no, nnompe mu ntini a ɛyɛ mmerɛw (nnompe mu ntini mu akuru) betumi aba. Nnipa kakraa bi a wɔwɔ Essential Thrombocythemia (ET) nso betumi anya mogya mu kokoram .

Bere bɛn na ɛsɛ sɛ mekɔ me duruyɛfo nkyɛn?

Di wo duruyɛfo akwankyerɛ a ɛfa mpɛn dodow a ɛsɛ sɛ wokɔ aduruyɛ mu nhwehwɛmu ne sɛ ebia ɛsɛ sɛ woyɛ mogya mu nhwehwɛmu de hwɛ wo mogya mu nkwammoaa dodow mu no akyi pɛpɛɛpɛ.

Bere bɛn na ɛsɛ sɛ mekɔ Emergency Department (ETU) ?

Sɛ wuhu sɛ wo ho yɛ wo yaw anaa komayare ho sɛnkyerɛnne a, frɛ 1990 ntɛm ara anaa kɔ ayaresabea dan a ɛbɛn wo a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu. Hwɛ saa sɛnkyerɛnne ahorow yi yiye.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Wubetumi abisa wo duruyɛfo nsɛm te sɛ:

• So ɛsɛ sɛ mehaw me ho wɔ mogya mu nkwammoaa a ɛdɔɔso a ɛwɔ me mu no ho?
• So ebehia sɛ meyɛ nhwehwɛmu pii na ama wɔasan ahwɛ sɛnea mogya mu nkwammoaa a ɛwɔ me mogya mu no te?
• Nhwehwɛmu bɛn na ebehia sɛ meyɛ na ama mahu nea ɛde me Thrombocytosis no ba?
• Ayaresa ahorow bɛn na wokamfo kyerɛ?
• Nsakrae bɛn na metumi ayɛ wɔ m’asetra kwan mu de adi tebea yi ho dwuma?

Sɛ wo mogya mu nhwehwɛmu kyerɛ sɛ wo mogya mu nkwammoaa a ɛdɔɔso a, mma wo ho nnpopo. Wo mogya mu nkwammoaa a ɛma mogya tu no betumi ayɛ kɛse esiane nneɛma ahorow nti. Nneɛma yi mu pii nhia ayaresa. Nanso sɛ wo dodow kɔ soro bere nyinaa na wowɔ sɛnkyerɛnne ahorow a, wo duruyɛfo no bɛbɔ mmɔden sɛ obehu nea ɛde ba. Mpɛn pii no, ahwɛyiye a wɔde hwɛ nneɛma so na wɔde nnuru di dwuma no betumi asiw nsɛnnennen a emu yɛ den sen biara a ɛbata thrombocytosis ho no ano.

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Wiɛ, yɛkaa Thrombocytosis ho asɛm pii nnɛ, ɛnte saa? Mewɔ anidaso sɛ wowɔ eyi ho ntease pa.

Ade a ɛho hia sen biara ne sɛ woremmɔ hu sɛ wuhu sɛ wo mogya mu nkwammoaa kɔkɔɔ dodow dɔɔso a. Ɛnyɛ Thrombocytosis nsɛm nyinaa na asiane wom.

• Reactive Thrombocytosis ne nea abu so sen biara, na mpɛn pii no, bere tiaa mu ade foforo na ɛde ba. Eyi nso bɛtu mpɔn bere a wɔasa saa ade a ɛde ba no.
• Essential Thrombocythemia (ET) yɛ ɔyare a ɛntaa nsi a ebia ebehia sɛ wodi ho dwuma bere tenten.
• Hwɛ hu sɛ wobɛyɛ nhwehwɛmu ne ayaresa a ɛfata sɛnea wo duruyɛfo akyerɛ wo no.
• Mmu w’ani ngu yare no ho sɛnkyerɛnne biara so. Hwehwɛ oduruyɛfo ntɛm ara, titiriw sɛ mogya tu wo soronko, wo ho yɛ wo yaw, wo ti yɛ wo yaw kɛse, wo koko yɛ wo yaw, anaasɛ ɛyɛ den sɛ wobɛhome a.
• Wo ne wo duruyɛfo nkasa pefee . Bisa nsɛm anaa nsɛm biara a ɛhaw wo.

Kae sɛ ɛnyɛ wo nko ara. Sɛ wonya aduruyɛ mu akwankyerɛ ne mmoa a ɛfata a, wubetumi adi tebea yi ho dwuma yiye na woanya asetra a ahoɔden wom.