So wo mogya mu nkwammoaa fitaa no so tew wɔ ɔkwan a ɛyɛ hu so? So ɛno yɛ agranulocytosis? Momma yɛnka ho asɛm!

So woyare bere nyinaa? So wote nka sɛ woayɛ mmerɛw na woabrɛ bere tiaa bi mpo? Ɛtɔ mmere bi a eyi betumi afi wo nipadua no ahobammɔ a ɛso atew wɔ ɔkwan a ɛyɛ hu so, a ɛne neutrophils, mogya mu nkwammoaa fitaa bi. Ɛnnɛ yɛreka tebea bi a emu yɛ den nanso wotumi sa a wɔfrɛ no agranulocytosis ho asɛm . Mma ɛnhaw wo, ɛho hia sɛ wuhu eyi.

Dɛn ankasa ne agranulocytosis?

Sɛ yɛbɛka no tiawa a, Agranulocytosis yɛ tebea a ɛde nkwa to asiane mu a mogya mu nkwammoaa fitaa a wɔfrɛ no neutrophils dodow a ɛwɔ yɛn nipadua mu no so tew kodu baabi a ɛba fam koraa. So wunim sɛ mogya mu nkwammoaa fitaa te sɛ asraafo a wɔwɔ yɛn nipadua mu tumi a ɛko tia nyarewa no mu? Wɔn na wɔbɔ yɛn ho ban fi mmoawa a wɔde nyarewa ba ho. Sɛ saa neutrophils yi dodow so tew a, yɛn nipadua no tumi nya mmoawa kɛse. Mmoawa a mpɛn pii no ɛnsɛe yɛn pii mpo betumi ama yɛayare. Wo de susuw ho hwɛ, sɛ asraafo dɔm titiriw bi a wɔwɔ yɛn man no asraafo mu yera mpofirim a, so ɔtamfo ketewaa bi mpo renyɛ ɔhaw kɛse? Eyi te saa ara. Edin "agranulocytosis" no fi asɛmfua granulocytes . Granulocytes nso yɛ mogya mu nkwammoaa fitaa bi. Enzyme ahorow a ɛsɛe mmoawa wɔ mu. Granulocytes ahorow abiɛsa na ɛwɔ hɔ: Neutrophils , Eosinophils, ne Basophils . Neutrophils ne mogya mu nkwammoaa fitaa a ɛdɔɔso sen biara wɔ yɛn nipadua mu. Ɛno nti na nnuruyɛfo sɔ neutrophil dodow hwɛ de hu agranulocytosis. Ɛtɔ mmere bi a wɔfrɛ eyi granulocytopenia .

Nsonsonoe bɛn na ɛda Neutropenia ne Agranulocytosis ntam?

Nneɛma abien no nyinaa ne neutrophils a ɛso tew wɔ abusuabɔ. Nanso, agranulocytosis ne neutropenia a emu yɛ den sen biara .

• Neutropenia yɛ tebea a ɛma neutrophils dodow a ɛwɔ mogya no mu no sua sen sɛnea ɛte daa. Wɔkyerɛ sɛ nnipa a neutrophils nnu 1,500 wɔ mogya microliter (mL) biara mu no wɔ neutropenia.
• Agranulocytosis ne ade a etwa to a asiane wom sen biara, bere a neutrophil dodow so tew ba fam sen 100 wɔ mogya microliter biara mu no. Ate aseɛ? Eyi ne neutropenia a emu yɛ den sen biara.

So agranulocytosis ahorow bi wɔ hɔ?

Yiw, eyi betumi aba akwan titiriw abien so: 1. Agranulocytosis a wonya fi awo mu:Eyi fi awosu mu yare bi. Ɛne sɛ, ɔhaw bi wɔ awosu mu nkwaadɔm a ɛboa yɛn nipadua ma ɛyɛ neutrophils no ho. Saa tebea yi ka nkokoaa ne mmofra nkumaa kɛse. 2. Agranulocytosis a wonya: Eyi betumi de nneɛma pii aba. Nanso, mpɛn pii no (bɛyɛ 70% wɔ bere no mu!) efi nnuru bi a yɛnom mu nsunsuanso bɔne bi. Saa ɔkwan yi taa ba mpanyimfo mu.

Saa tebea yi abu so dɛn?

Eyi yɛ tebea a ɛntaa nsi koraa ankasa. Sɛ wɔkyekyem pɛpɛɛpɛ a, nnipa mpem ɔha biara mu bɛyɛ baason nya saa tebea yi afe biara. Enti mma suro a ɛho nhia, nanso ɛho hia sɛ wohu.

Dɛn ne Agranulocytosis ho sɛnkyerɛnne ahorow?

Wɔ eyi mu no, sɛnkyerɛnne atitiriw no fa ɔyare mmoawa ho. Eyinom betumi afi ase mpofirim, anaasɛ ebetumi adɔɔso nkakrankakra bere a bere kɔ so no. Hwɛ sɛ saa sɛnkyerɛnne ahorow yi te sɛ nea wunim anaa:

• Atiridiinini a obi nya, awɔw a ɔte nka na ne ho popo.
• Koma a ɛbɔ ne ɔhome a ɛkɔ soro.
• Nkwa a enni hɔ ne ɔbrɛ a ɛtra so a wɔte nka.
• Menewa mu yaw (pharyngitis), anom ntini a ɛkɔ fam, mogya a ɛtɔ gu anom .
• Ano ne menewa mu akuru , na ɛma ɛyɛ den sɛ wobɛmene aduan ne anonne.
• Mogya mmoroso a ɛba fam mpofirim (hypotension), adwenemhaw, adwenemhaw, na ebia mpo obi ntumi nhu hwee.

Sɛ wowɔ sɛnkyerɛnne ahorow te sɛ eyinom, titiriw sɛ ɛtaa ba a, akyinnye biara nni ho sɛ ɛsɛ sɛ wohwehwɛ aduruyɛfo afotu.

Dɛn nti na agranulocytosis ba? Dɛn na ɛde ba?

Nea enti titiriw a ɛte saa ne mogya mu nkwammoaa fitaa a wɔfrɛ no neutrophils a ɛwɔ yɛn nipadua mu no so tew wɔ ɔkwan a ɛyɛ hu so. Nneɛma abien na ebetumi ama eyi aba:

• Ebia yɛn nipadua no ntumi nyɛ neutrophils a ɛdɔɔso na ama ayɛ adwuma yiye.
• Sɛ ɛnte saa a, neutrophils a ɛwɔ nipadua no mu no sɛe, anaasɛ ewuwu ntɛm.

Afei ma yɛnhwɛ nea enti pɔtee a enti ɛte saa.

Agranulocytosis a wonya fi awo mu

Wɔ eyi mu no, ɔhaw bi wɔ awosu mu abɔde bi a ɛboa ma wɔyɛ neutrophils ho. Eyi yɛ tebea a ɛwɔ hɔ wɔ awo mu (awo mu). Sɛ nhwɛso no, sɛ yɛfa Kostmann syndrome , anaa congenital agranulocytosis , tebea a ɛntaa nsi a, nkokoaa a wɔawo wɔn foforo taa nya ɔyare mmoawa, atiridiinini, ɔfe, ne nnompe mu haw.

Agranulocytosis a wonyae

Ebia nneɛma ahorow bi nti na ɛte saa. Ma yɛnhwɛ nea wɔyɛ:

• Nnuru bi: Eyi ne nea ɛtaa de ba . Nnuru bi a ekum ɔyare mmoawa , nnuru a ekum adwenemhaw , ne thyroid nnuru betumi de tebea yi aba.
• Autoimmune diseases : Eyinom yɛ nyarewa a nipadua no mu tumi a ɛko tia nyarewa no tow hyɛ nipadua no ankasa nkwammoaa so. Nhwɛso ahorow bi ne lupus ne ntini mu yare .
• Nnompe mu ntini mu nyarewa ne nnompe mu ntini a entumi nyɛ adwuma yiye: Sɛ nhwɛso no , aplastic anemia . Nnompe mu ntini ne baabi a wɔyɛ yɛn mogya mu nkwammoaa.
• Kokoram: Kokoram a ɛka nnompe mu ntini, titiriw mogya mu kokoram .
• Kokoram ayaresa (Chemotherapy): Saa ayaresa yi betumi asɛe nkwammoaa a ɛwɔ apɔwmuden ne neutrophils nso.
• Awuduru anaa nnuru a wɔde di dwuma: Nneɛma te sɛ kɔbere anaa mercury a wɔde wɔn ho hyɛ mu bere tenten.
• Nyarewa: Nyarewa a emu yɛ den te sɛ asramma , nsamanwaw , ne Rocky Mountain spotted fever .
• Aduan pa a enni nipadua mu: Aduannuru a ɛho hia te sɛ Vitamin B12 ne Folate a enni hɔ.

Hena na ɔwɔ asiane kɛse mu ma tebea yi?

Mmea taa nya saa tebea yi kakra sen mmarima. Afei nso, agranulocytosis betumi aka obiara a wadi mfe biara. Nanso, nnipa a wodi so yi na wɔwɔ asiane mu titiriw:

• Nnipa a wɔreyɛ wɔn nnuru a wɔde sa kokoram.
• Nnipa a wɔwɔ nyarewa a nipadua no tumi ko tia nyarewa te sɛ lupus ne ntini mu yare .
• Nnipa a wɔnom nnuru bi, te sɛ Clozapine (Clozaril®) , aduru a ekum adwene mu yare , Trimethoprim/sulfamethoxazole (BactrimTM) , ne Methimazole (Tapazole®), aduru a wɔde kum thyroid.

Dɛn ne nsɛnnennen a ebetumi aba esiane agranulocytosis nti?

Saa tebea yi betumi ama obi anya ɔyare mmoawa a wɔtaa nya anaasɛ ɛtra hɔ kyɛ (nyarewa a enni sabea).

Sɛ agranulocytosis kɔ so bɛboro adapɛn abiɛsa kosi anan a, hokwan 100% wɔ hɔ sɛ obenya ɔyare mmoawa.

Sɛ wɔansa sepsis a, ebetumi ama nipadua no mu tumi a ɛko tia nyarewa no ayɛ ade a emu yɛ den a ɛde ne nkwa to asiane mu a wɔfrɛ no sepsis. Sepsis yɛ ɔyare mmoawa a emu yɛ den a ɛtrɛw kɔ nipadua no mu nyinaa. Nnipa a wɔadi boro mfe 65 anaa wɔn a wɔwɔ akwahosan ho haw afoforo te sɛ komayare, asaabo mu yare, anaa ahurututu mu yare no wɔ asiane kɛse mu sɛ wobenya saa nsɛnnennen yi.

Wobɛyɛ dɛn ahu eyi?

Ɔkwan bɛn so na oduruyɛfo hu agranulocytosis? Wɔtaa di anammɔn yi akyi:

• Mogya Dodow a Edi Mu (CBC) ne nsonsonoe: Saa sɔhwɛ yi hwɛ nkwammoaa ahorow a ɛwɔ wo mogya mu, titiriw neutrophils dodow. Wobu neutrophil dodow a edi mũ (ANC) a ennu 100 wɔ mogya microliter biara mu sɛ agranulocytosis. (Bo a ɛfata ma obi a ɔwɔ apɔwmuden boro 1,500.)
• Nnompe mu ntini mu nhwehwɛmu ne aspirate: Ɛtɔ mmere bi a, wobetumi ayɛ nhwehwɛmu yi de ahu sɛnea wo nnompe mu ntini no reyɛ neutrophils.
• Nsɛnkyerɛnne ne aduruyɛ ho abakɔsɛm: Oduruyɛfo no bebisa wo wo yare no ho sɛnkyerɛnne, nnuru a wonom, nyarewa a woanya nnansa yi, ne nnuru biara a wode wo ho bɛhyɛ mu ho asɛm.
• Awosu mu nhwehwɛmu: Sɛ wosusuw sɛ awosu mu tebea bi wɔ hɔ a, wobetumi ayɛ awosu mu nhwehwɛmu de asi so dua. Ebia eyi bɛhwehwɛ sɛ wɔyɛ honam ani nhwehwɛmu anaa mogya mu nhwehwɛmu.

Dɛn ne ayaresa ahorow a wɔde sa eyi?

Asɛmpa no ne sɛ ayaresa ahorow wɔ hɔ a wɔde sa tebea yi, agranulocytosis. Ayaresa no gyina nea ɛde ba no so.

• Aduru a Ɛde Ba no a Wobɛgyae: Sɛ aduru bi na ɛde wo yare no ho sɛnkyerɛnne reba a, ade a edi kan a ɛsɛ sɛ woyɛ ne sɛ wubegyae nom dwoodwoo sɛnea wo duruyɛfo kyerɛ no. Nnyae nnuru nom da a wonkɔ oduruyɛfo nkyɛn.
• Nnuru a ekum ɔyare mmoawa: Sɛ wowɔ ɔyare mmoawa bi a, wo duruyɛfo bɛkyerɛw nnuru a ɛfata a ekum ɔyare mmoawa ne nnuru afoforo na ama yare no ho sɛnkyerɛnne so atew.
• Granulocyte colony-stimulating factor (G-CSF): Wobetumi de saa aduru yi ama nipadua no ma ayɛ neutrophils ntɛmntɛm. Nhwɛso ahorow bi ne nnuru te sɛ Filgrastim (Neupogen®) , Pegfilgrastim (Neulasta®) , ne Lenograstim (Granocyte®) .
• Nnuru a ɛma nipadua no tumi ko tia nyarewa: Sɛ ɔyare a nipadua no tumi ko tia nyarewa na ɛde tebea no ba a, wobetumi akyerɛw nnuru a esiw nipadua no mu tumi a ɛko tia nyarewa ano te sɛ Prednisone ama.
• Nnompe mu ntini a wɔde si ananmu: Sɛ ayaresa afoforo antumi anyɛ yiye a, ebia ebehia sɛ wɔma wo nnompe mu ntini foforo. Wɔ eyi mu no, wɔbɛma wo nnompe mu ntini a efi obi a ɔwɔ apɔwmuden a ɔde ma no hɔ. Eyi bɛboa wo nipadua no ma ayɛ neutrophils a ɛte apɔw bio.
• Nyarewa a wobesiw ano: Eyi ho hia yiye. Ɛsɛ sɛ nnipa a wɔwɔ saa tebea yi hwɛ yiye paa na wɔakwati nyarewa.
• Fa samina hohoro wo nsa yiye bere nyinaa.
• Kwati mmeae a nnipa ahyɛ hɔ ma sɛnea wubetumi biara.
• Hyɛ anim katasoɔ/akatasoɔ bere a worekɔ abɔnten no.
• Wo ne wo duruyɛfo nkasa mfa nea wubetumi ayɛ bio de asiw yare ano ho asɛm.

Me ho bɛtɔ me ntɛm dɛn bere a wɔasa me yare awie no?

Bere a wo ho bɛtɔ wo no gyina nea ɛde wo neutrophil dodow a ɛba fam ba ne sɛnea tebea no mu yɛ den so. Sɛ ɛyɛ aduru bi mu nsunsuanso bɔne a, mpɛn pii no ebetumi agye dapɛn biako kosi adapɛn abiɛsa ansa na wo neutrophil dodow asan ayɛ sɛnea na ɛte bere a woagyae aduru no nom no.

So wobetumi asiw eyi ano?

Ɛtɔ mmere bi a, wontumi nsiw agranulocytosis ano koraa. Nanso, sɛ worenom aduru bi a ebetumi atew wo neutrophils so (e.g., chemotherapy, adwenemyare nnuru bi) a, ɛho hia sɛ wo ne wo duruyɛfo kasa na woma wɔhwɛ wo neutrophil dodow daa. Sɛ woreyɛ nnuru a wɔde sa kokoram a, ebia wo duruyɛfo bɛkamfo G-CSF a wɔde bɛhyɛ wo mu na aboa ma neutrophil a wɔyɛ no akɔ soro.

Dɛn ne obi a ɔwɔ agranulocytosis no anidaso?

Ɛwom sɛ eyi yɛ tebea a wotumi sa de, nanso ɛsono nea efi mu ba. Sɛ wɔsa no yare yiye, anaasɛ sɛ wogyae aduru a ɛtew neutrophils so a, tebea no taa fi hɔ.

Nanso, sɛ wɔansa a, nyarewa a emu yɛ den ne owu mpo betumi aba. Dodow a neutrophil dodow kɔ so yɛ nea asiane wom no, dodow no ara na asiane a ɛwɔ hɔ sɛ wobenya ɔyare mmoawa ne nsɛnnennen no yɛ kɛse. Eyi te saa titiriw ma nnipa a wɔadi boro mfe 65 ne wɔn a wɔwɔ ayaresa tebea horow a ɛda adi pefee (te sɛ asaabo, koma, anaa ahurututu mu yare).

Bere bɛn na ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn?

Agranulocytosis yɛ tebea a ɛde nkwa to asiane mu. Enti, ɛho hia sɛ wonya ɔyare no ho nhwehwɛmu ne ayaresa ntɛm ara. Sɛ wowɔ saa sɛnkyerɛnne yi bi a, kɔ oduruyɛfo nkyɛn ntɛm ara:

• Sɛ wotaa nya nyarewa a.
• Sɛ ɔyare mmoawa no gye bere tenten ansa na ayɛ yiye a.
• Sɛ wunya ɔyare mmoawa ho sɛnkyerɛnne te sɛ atiridiinini, atiridiinini, anaa menewam yaw a.

Sɛ wowɔ yare bi a nipadua no tumi ko tia nyarewa anaasɛ worenom nnuru a ɛma wo neutrophils no so tew a, ntwa wo aduruyɛ mu nhwehwɛmu ahorow no so. Wo duruyɛfo a wobɛkɔ akɔhwɛ wo daa no betumi aboa wo ma woahwɛ wo neutrophil dodow na aboa ma woasiw nyarewa ano.

Nneɛma a ɛho hia paa a ɛsɛ sɛ yɛkae (Take-Home Message) .

Okay, enti momma yɛnsan nsusuw nsɛntitiriw a ɛho hia sen biara no bi ho mfi nea yɛaka ho asɛm no mu:

• Agranulocytosis yɛ tebea a emu yɛ den nanso wotumi sa a mogya mu nkwammoaa fitaa a wɔfrɛ no neutrophils so tew kɛse.
• Sɛ wowɔ sɛnkyerɛnne ahorow te sɛ ɔyare mmoawa a wotaa nya, atiridiinini, anaa wo menewa mu yaw a, kɔ oduruyɛfo nkyɛn ntɛm ara.
• Eyi betumi afi nnuru bi, nyarewa a nipadua no tumi ko tia nyarewa, ne kokoram ayaresa.
• Ebia ayaresa no bi ne aduru a ɛhyɛ abufuw no a wobegyae, nnuru a ekum ɔyare mmoawa, G-CSF a wɔde twitwiw nipadua no mu, ne ebia nnompe mu ntini a wɔde bɛma obi foforo.
• Wo ho ban a wobɛbɔ afi ɔyare mmoawa ho no ho hia yiye. Wubetumi abɔ wo ho ban denam nneɛma a ɛnyɛ den te sɛ wo nsa a wobɛhohoro mpɛn pii ne akataso a wobɛhyɛ bere a wowɔ baguam no so.
• Sɛ wowɔ asiane mu ma eyi (e.g., sɛ wonom nnuru bi a), ntwa oduruyɛfo nkyɛn.

Mewɔ anidaso sɛ saa nsɛm yi ho bɛba wo mfaso. Kɔ so nya apɔwmuden!