Dɛn ne Evans Syndrome? Momma yɛnka ho asɛm!

So ɛtɔ mmere bi a wote nka sɛ woabrɛ? Anaasɛ ɛyɛ den ma wo sɛ wubegyae mogya a efi nneɛma nketenkete mpo mu? Ebia ɛyɛ nea wo nipadua mu tumi a ɛko tia nyarewa no reyɛ adwuma atia wo nti. Ɛnnɛ yɛrebɛka tebea a ɛte saa a ɛntaa nsi nanso ɛho hia yiye a ɛsɛ sɛ yehu ho asɛm. Ɛno ne Evans Syndrome . Mma ɛnhaw wo, yɛbɛka biribiara ho asɛm wɔ nsɛm a ɛnyɛ den mu.

Enti, dɛn ne Evans Syndrome?

Sɛ yɛbɛka no tiawa a, Evans Syndrome yɛ yare a nipadua no tumi ko tia nyarewa . Nea ɛba ne sɛ asraafo a wɔkyerɛ sɛ wɔbɔ yɛn nipadua, nipadua no mu tumi a ɛko tia nyarewa no ho ban no di mfomso fi ase sɛe yɛn ankasa mogya mu nkwammoaa no bi. Ɛte sɛ yɛn ankasa asraafo a wɔreto ahyɛ yɛn ankasa nkurɔfo so. Ne saa nti, yɛn nipadua no hwere mogya mu nkwammoaa dodow a ɛho hia. Saa mogya mu nkwammoaa a ɛso tew wɔ ɔkwan a ɛnteɛ so yi ne nea yɛfrɛ no cytopenia wɔ nnuruyɛ mu.

Nnipa dodow no ara a wɔwɔ Evans Syndrome no, mogya mu nkwammoaa kɔkɔɔ a ɛba fam (tebea bi a wɔfrɛ no mogya a ɛtɔ kɔ nipadua mu ) ne mogya mu nkwammoaa a ɛma mogya tu (yare a wɔfrɛ no thrombocytopenia ) na edi kan ka wɔn. Wɔ abien no nyinaa akyi no, ebia nnipa binom nso wɔ mogya mu nkwammoaa fitaa bi a wɔfrɛ no neutrophils (yare bi a wɔfrɛ no neutropenia ) dodow a ɛba fam.

Sɛ mogya mu nkwammoaa ahorow yi sua a, nneɛma a ɛho hia pii wɔ yɛn nipadua mu, te sɛ mframa pa a yebenya, mogya a ɛtwetwe, ne nyarewa a yɛko tia no ka. Ɛno nti na yɛte nka sɛ yɛayɛ mmerɛw, yɛabrɛ, yefi ase mogya tu ntɛmntɛm, na yɛyare mpɛn pii no .

Saa tebea yi betumi aka nnipa binom brɛoo koraa, bere a afoforo nso betumi ayɛ nea emu yɛ den koraa. Na nea efi mu ba no ntra hɔ daa wɔ nkwa nna nyinaa mu. Nea eye sen biara ne sɛ ɛwom sɛ wonni ano aduru biara de, nanso ayaresa betumi aboa ma wɔadi sɛnkyerɛnne ahorow no so na ama nea efi mu ba no so atew .

Dɛn ne Evans Syndrome ho sɛnkyerɛnne ahorow?

Evans Syndrome ho sɛnkyerɛnne betumi ayɛ soronko kɛse. Egyina cytopenia ko a wowɔ ne sɛnea emu yɛ den no so. Mpɛn pii no, mogya a ɛtɔ kɔ nipadua mu anaa mogya mu nkwammoaa a ɛma mogya tu no di kan ba, na afoforo no pue akyiri yi.

Mogya mu nkwammoaa kɔkɔɔ a enni nipadua mu ( mogya a ɛtɔ kɔ nipadua mu ) ho sɛnkyerɛnne a edi kan : .

So woabrɛ bere a wonantew kwan tiaa bi mpo akyi? So wote nka sɛ woabrɛ na wuntumi nyɛ nneɛma a na woyɛ kan no? Ebia w’anim reyɛ ayɛ mmerɛw kakra. Eyinom ne mogya a ɛtɔ kɔ nipadua mu ho sɛnkyerɛnne a edi kan no bi :

• Ɔbrɛ a ɛtra so a wɔte nka ara kwa .
• Wora a ɛyɛ mmerɛw (a ɛyɛ mmerɛw) .
• Ti a ɛyɛ hare anaasɛ adwenemhaw .
• Ɔhome a ɛyɛ den (dyspnea) .
• Koma a ɛbɔ ntɛmntɛm (tachycardia) .
• Sɛ wote nka anaasɛ wobɛte nka sɛ wo koma rebɔ wɔ ɔkwan a ɛnteɛ so (koma a ɛbɔ) .

Nsɛnkyerɛnne a edi kan a ɛkyerɛ sɛ mogya nkwammoaa a enni nipadua mu (thrombocytopenia):

So woahyɛ no nsow sɛ ɛtɔ mmere bi a nsensanee kɔkɔɔ nketenkete pue wɔ wo honam ani? Anaasɛ wunya akuru wɔ wo nipadua nyinaa so kɛkɛ? So wote nka sɛ mogya retu wo ntini mu sen sɛnea wotaa yɛ bere a worehohoro wo sẽ no? Eyinom ne sɛnkyerɛnne ahorow a ebetumi aba sɛ mogya nkwammoaa a ɛwɔ mogya mu no so tew:

• Mogya nketenkete kɔkɔɔ a ɛretu (petechiae) wɔ honam ani.
• Nsonsonoe a ɛyɛ kɔkɔɔ wɔ honam ani (purpura) .
• Bruising (ecchymosis) a ɛba a ɛnyɛ nea ɛde ba.
• Mogya a ɛtɔ dodo fi anom anaa hwene mu.
• Mogya a ɛtɔ kɛse bere a mmea rekɔ brayɛ mu.
• Mogya a ɛba denam nsu anaa nsu a wɔde gu mu so.

Neutropenia ho sɛnkyerɛnne (eyinom betumi aba akyiri yi anaasɛ ɛremma):

Ɛyɛ ade a ɛfata sɛ wubenya atiridii biako anaa abien ɔsram biara. Nanso so atiridii taa yare? So w’ano yɛ wo yaw bere nyinaa? So ɛte sɛ nea egye bere tenten ansa na wɔasa? Nneɛma bi a ebetumi asi bere a wo neutrophils no sua ni:

• Huraeɛ.
• Ano mu akisikuru .
• Atiridiinini, atiridiinini, ne yafunu a ɛtaa yɛ no yaw.
• Aso mu yare a ɛsan ba bio.
• Fungal yare a ɛtra hɔ kyɛ.
• Nsuo mu yareɛ (UTIs) .

Evans Syndrome ho sɛnkyerɛnne afoforo (eyinom betumi aba bere ne bere mu):

• Ntini a ɛho ahonhon wɔ kɔn mu.
• Akisikuru a ayɛ kɛse .
• mmerɛbo a ayɛ kɛse .
• Jaundice a ɛyɛ mmerɛw .

Dɛn nti na Evans Syndrome ba?

Sɛnea yɛadi kan aka no, Evans Syndrome yɛ yare a nipadua no tumi ko tia nyarewa . Wei kyerɛ sɛ yɛn nipadua mu nipadua mu ahoɔden a ɛko tia nyarewa no di mfomso hu yɛn ankasa mogya mu nkwammoaa bi sɛ "atamfo" na efi ase tow hyɛ wɔn so.

B nkwammoaa, nkwammoaa soronko bi a ɛwɔ yɛn nipadua mu ahoɔden a ɛko tia nyarewa mu no na ɛyɛ adwuma yi. Saa B nkwammoaa yi yɛ biribi a wɔfrɛ no antibodies . Saa nnuru a ɛko tia nyarewa yi kɔ kyere saa mogya mu nkwammoaa a ɛho nni asɛm no na ɛsɛe wɔn. Mpɛn pii no, wofi ase tow hyɛ mogya mu nkwammoaa bi so kan, na afei wotumi fi ase tow hyɛ mogya mu nkwammoaa ahorow afoforo so.

Saa adeyɛ yi ne nea awiei koraa no ɛma anyɛ yiye koraa no mogya mu nkwammoaa ahorow abien (cytopenia) ho sintɔ, na ɛtɔ mmere bi a abiɛsa no nyinaa. Wɔfrɛ nea enni abiɛsa no nyinaa mu no pancytopenia . Tebea atitiriw abiɛsa a ɛma mogya mu nkwammoaa yi sua ne:

• mogya a ɛtɔ kɔ mogya mu a nipadua no tumi ko tia nyarewa (AIHA) .: Eyi ne bere a mogya mu nkwammoaa kɔkɔɔ so tew. Ɛne sɛ, wɔsɛe wɔn ntɛmntɛm sen sɛnea nipadua no betumi ayɛ.
• Immune thrombocytopenia (ITP) : Eyi yɛ tebea a ɛma mogya nkwammoaa so tew. Nkwammoaa a ɛko tia nyarewa no tow hyɛ mogya mu nkwammoaa a ɛma mogya tu fi mogya no mu na eyi fi hɔ.
• Autoimmune neutropenia (AIN) : Eyi yɛ tebea a ɛma neutrophils, mogya mu nkwammoaa fitaa bi, dodow so tew. Nkwammoaa a ɛko tia nyarewa no tow hyɛ neutrophils no so na ɛsɛe.

Susuw ho hwɛ, nneɛma pii betumi ama mogya mu nkwammoaa dodow a ɛba fam (cytopenia). Ɛtɔ mmere bi a ebetumi aba sɛ nnompe mu ntini no ntumi nyɛ mogya mu nkwammoaa a ɛdɔɔso nti. Nanso, wɔ autoimmune cytopenia mu no, nipadua no mu tumi a ɛko tia nyarewa no sɛe n’ankasa mogya mu nkwammoaa.

Dɛn ne nneɛma a ɛkanyan Evans Syndrome?

Nyansahufo da so ara nnim nea enti a nyarewa a nipadua no tumi ko tia nyarewa yi ba ankasa. Nanso wɔahu sɛ mpɛn pii no, nyarewa yi fi ase wɔ yare a emu yɛ den anaa adeyɛ bi a ɛde adwennwen kɛse ba nipadua no mu tumi a ɛko tia nyarewa no so akyi. Wɔfrɛ eyinom sɛ nneɛma a ɛkanyan obi .

Afei nso, sɛ wowɔ yare biako a nipadua no tumi ko tia nyarewa a, akontaabu kyerɛ sɛ ɛda adi sɛ wubenya foforo. Ɛte sɛ nea saa nipadua no fã bi a ɛko tia nyarewa yi trɛw fi nipadua no fã biako kɔ foforo.

Evans yare no betumi aba n’ankasa (wɔfrɛ eyi Evans yare titiriw ), anaasɛ ebetumi aba sɛ tebea a ɛto so abien a ɛne tebea foforo wɔ abusuabɔ (wɔfrɛ eyi Evans yare a ɛto so abien) . Tebea horow a wobetumi de abata ho wɔ saa kwan yi so no bi ne:

• Lupus a ɛwɔ nipadua no mu a ɛma mogya tu (lupus) .
• Nkwammoaa a ɛko tia nyarewa a ɛtaa ba a ɛsakrasakra
• IgA a wɔpaw a enni hɔ
• Sjögren yare a ɛma obi nya ɔyare no
• Lymphoma a ɛnyɛ Hodgkin
• Leukemia a enni sabea a ɛma mogya tu
• Hepatitis C a enni sabea
• HIV a enni sabea

Sɛ wowɔ Evans syndrome titiriw a, ebia ɛbaa bere tiaa mu yare akyi, anaasɛ ebia wunni nea ɛkanyan wo pefee. Nyansahufo bu Evans yare no mu sɛ tebea a ɛyɛ idiopathic . Eyi kyerɛ sɛ wonhuu biribiara a ɛde ba tẽẽ.

Dɛn ne nsɛnnennen a ebetumi afi Evans Syndrome mu aba?

Ɛnyɛ obiara a ɔwɔ Evans Syndrome na obenya nsɛnnennen. Nnipa binom nya yare no ho sɛnkyerɛnne a emu nyɛ den koraa. Nanso, wɔ tebea horow a emu yɛ den mu no, mogya mu nkwammoaa a enni nipadua no mu (cytopenias) yi betumi de nkwa ato asiane mu. Nhwɛsoɔ:

• Sɛ mogya mu nkwammoaa kɔkɔɔ a ɛdɔɔso nni hɔ a ɛbɛma oxygen akɔ nipadua no mu a, oxygen a ɛdɔɔso nni mogya no mu (hypoxemia) . Eyi yɛ den ma koma no yiye na ebetumi ama obi anya komayare ne komayare.
• When you don't have enough platelets , which help your blood clot, your blood doesn't clot properly. Eyi betumi ama mogya atɔ wo ntɛmntɛm na ayɛ ntɛm. Eyi betumi ama mogya atɔ nipadua no mu ayɛ den ntɛm ara.
• Sɛ wo nipadua no hwere neutrophils , a ɛboa ma wɔko tia ɔyare mmoawa a, ɛda adi sɛ wubenya nyarewa mpɛn pii, na ebetumi ayɛ den na atrɛw wɔ wo nipadua nyinaa mu. Eyi betumi ama obi anya tebea bi a asiane wom a wɔfrɛ no sepsis .

Ɔkwan bɛn so na nnuruyɛfo hu Evans Syndrome?

Wɔnam mogya mu nhwehwɛmu so hu Evans Syndrome . Ebia wobehu sɛ wunya cytopenia ho sɛnkyerɛnne, anaasɛ bere a wɔreyɛ mogya mu nkwammoaa dodow bere a wɔreyɛ akwahosan ho nhwehwɛmu daa no.

Sɛ wo Complete Blood Count (CBC) kyerɛ sɛ wo mogya mu nkwammoaa kɔkɔɔ, mogya mu nkwammoaa, anaa neutrophils sua a, w’aduruyɛfo kuw no bɛyɛ nhwehwɛmu pii. Sɛ nhwɛso no, wɔbɛhwɛ wo mogya mu sɛ ebia nnuru a ɛko tia nyarewa a ɛne Evans Syndrome wɔ abusuabɔ no dodow akɔ soro anaa. Wɔbɛhwɛ nso sɛ tebea afoforo a ebetumi ama cytopenia aba, te sɛ ɔyare mmoawa bi anaa kokoram.

Nnuruyɛfo si Evans Syndrome no so dua denam nneɛma afoforo a ɛde ba nyinaa a wɔpow no so. Ɛtɔ mmere bi a, ebia ɛho behia nso sɛ wɔyɛ CT scan (computed tomography scan) anaa nnompe mu ntini mu nhwehwɛmu na ama wɔahu tebea afoforo.

So aduru bi wɔ hɔ a edi mũ a wɔde sa Evans Syndrome? Ɔkwan bɛn so na wɔsa?

Nokwarem no, wonni Evans Syndrome, anaa yare foforo biara a nipadua no tumi ko tia nyarewa no ano aduru koraa . Nnuruyɛfo sa nyarewa a nipadua no tumi ko tia nyarewa yi denam nnuru a wɔma wo a ɛtew wo nipadua mu tumi a ɛko tia nyarewa no dwumadi so no so.

Bio nso, wobetumi asa wo yare no ho sɛnkyerɛnne no wɔ ɔkwan soronko so. Sɛ nhwɛso no, sɛ wo mogya mu nkwammoaa dodow sua koraa a, ebia wo duruyɛfo betumi de mogya a wɔde ma bere ne bere mu asiesie eyi .

Te sɛ nyarewa pii a nipadua no tumi ko tia nyarewa a ɛtra hɔ kyɛ no, Evans Syndrome betumi ayɛ yiye na bere kɔ so no. Ɛtɔ mmere bi a, ɛbɛyɛ te sɛ nea sɛnkyerɛnne ahorow no fi hɔ (a wɔfrɛ no remission) , nanso afei ebetumi asan aba anaasɛ asɛe (a wɔfrɛ no relapse ).

Ebia ebehia sɛ wosɔ ayaresa ahorow hwɛ wɔ w’asetra nyinaa mu, efisɛ bere kɔ so no, sɛnea wodi yiye no betumi ayɛ soronko. Wo duruyɛfo bɛbɔ mmɔden sɛ ɔbɛbɔ wo ho ban afi Evans Syndrome mu nsɛnnennen a emu yɛ den sen biara no ho.

Dɛn ne ayaresa ahorow no?

Evans Syndrome ayaresa a wɔtaa de di dwuma ne nnuru a ɛma nipadua no tumi ko tia nyarewa ne sɛ ɛho hia a, mogya a wɔde ma. Saa nnuru a ɛma nipadua no tumi ko tia nyarewa yi yɛ adwuma denam ntua a wo nipadua no tumi ko tia nyarewa no di mfomso a ɛtew so no so.

Nnuru ahorow atitiriw a wɔde ma:

• Corticosteroids te sɛ prednisone . Mpɛn pii no, eyi ne ayaresa a edi kan a wɔde ma.
• Nea ɛka immunoglobulin a wɔde fa ntini mu (IVIg) ho ne sɛ wɔde aduru bi a nnipa nipadua mu nkwammoaa a ɛko tia nyarewa wom fa ntini bi mu ma. Saa nnuru foforo a ɛko tia nyarewa yi betumi akyekyere nipadua mu nkwammoaa a ɛko tia nyarewa a ɛdi mfomso no na ama wɔadi dɛm.

Sɛ woannye ayaresa a wɔahyɛ da ayɛ no yiye a, ebia wo duruyɛfo bɛsɔ ayaresa afoforo ahwɛ. Eyinom bi ne:

• Nnuru a ɛko tia nyarewa a ɛyɛ monoclonal te sɛ rituximab . Eyinom yɛ nnuru a ɛko tia nyarewa a wɔayɛ wɔ lab. Ɛtɔ mmere bi a eyinom betumi agyae nipadua no mu tumi a ɛko tia nyarewa no. Ebia wo duruyɛfo bɛkyerɛ eyinom sɛ nnuru afoforo ntumi nyɛ adwuma a.
• Splenectomy a wɔtwa . Wɔ tebea horow a emu yɛ den mu no, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ wo oprehyɛn mfa yi w’akyi berɛmo. Wo dwensɔtwaa ne baabi a woyi mogya mu nkwammoaa dedaw no fi hɔ. Enti sɛ woyi akyi berɛmo no fi hɔ a, adeyɛ no brɛ ase kakra.

So nsɛnnennen anaa nsunsuanso bɔne bi wɔ ayaresa no mu?

Sɛ wonom nnuru a ɛma nipadua no tumi ko tia nyarewa a, sɛnea wo nipadua mu tumi a ɛko tia nyarewa no yɛ adwuma wɔ wo yare a nipadua no tumi ko tia nyarewa no ho no so tew. Nanso, tumi a ɛko tia nyarewa nso so tew . Enti ɛho behia sɛ woyɛ ahwɛyiye titiriw na amma worenyare.

Ebia wo duruyɛfo bɛkamfo nnuru foforo a wɔde bɔ wo ho ban aka nea woanya dedaw no ho. Sɛ wo nipadua mu tumi a ɛko tia nyarewa no yɛ mmerɛw (nkwammoaa a ɛko tia nyarewa no ayɛ mmerɛw) a, ebia wo ho bɛtɔ wo kɛse sɛ wubenya nyarewa a anka worennya bi.

So Evans Syndrome a obi bɛtra ase no ka nkwa nna?

Ɛnyɛ nea ɛkyerɛ sɛ Evans Syndrome ka wo nkwa nna. Nnipa binom nya yare no ho sɛnkyerɛnne a emu nyɛ den koraa, bere ne bere mu nkutoo. Nanso, ɔhaw ahorow bi te sɛ mogya a ɛtɔ, komayare, ne ɔyare mmoawa betumi de nkwa ato asiane mu.

Sɛ wowɔ Evans syndrome a ɛto so abien, a ɛkyerɛ sɛ wowɔ bi ne tebea foforo a enni sabea a, ɛno nso betumi aka wo nkwa nna. Ebia wubenya nsɛnnennen a ɛde wo nkwa to asiane mu a ɛka wo tebea foforo no ho.

Dɛn ne obi a ɔwɔ Evans Syndrome no anidaso?

Nnipa a wɔwɔ Evans Syndrome suahu ahorow gu ahorow kɛse. Nsɛnkyerɛnne no betumi ayɛ nea emu nyɛ den anaasɛ emu yɛ den. Nnipa binom te nka sɛ wɔn sɛnkyerɛnne no kɔ koraa (remission). Afoforo nso san nya bi akyiri yi (san ba).

Nnipa pii hia ayaresa bi ne aduruyɛ mu nhwehwɛmu a wɔyɛ no daa. Ayaresa taa yɛ adwuma yiye, nanso ɛnyɛ bere nyinaa. Ɛtɔ mmere bi a, ebetumi ayɛ te sɛ nea ayaresa ahorow a etu mpɔn no so tew bere a bere kɔ so no. Ebia ebehia sɛ wosɔ ayaresa afoforo hwɛ.

Meyɛ dɛn hwɛ me ho bere a mete Evans Syndrome no?

Sɛ wowɔ Evans Syndrome a, ɛho hia sɛ wokɔ so yɛ wo aduruyɛ mu nhwehwɛmu daa . Sɛ wo ho tɔ wo mpo a, wo duruyɛfo bɛpɛ sɛ ɔhwɛ wo tebea no so na sɛ ɛyɛ kɛse a, ɔbɛkyere no ntɛm.

Afei nso, ɛsɛ sɛ wohwɛ wo ho yiye bere nyinaa na wohwɛ sɛnea yare no ho sɛnkyerɛnne foforo biara bɛba. Sɛ wowɔ atiridiinini a ɛnyɛ yiye, anaasɛ mogya retu wo a wuntumi nni so a, frɛ wo duruyɛfo ntɛm ara .

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Ebia wobɛpɛ sɛ wubisa wo duruyɛfo nsɛm te sɛ eyinom:

• Mogya mu nkwammoaa ahorow bɛn na minni?
• Wɔn so atew ahe?
• Nsɛnkyerɛnne anaa kɔkɔbɔ nsɛnkyerɛnne bɛn na ɛsɛ sɛ mehwɛ yiye?
• Mɛyɛ dɛn ahu sɛ ayaresa no reyɛ adwuma anaasɛ ɛnte saa?
• Sɛ ayaresa no anyɛ adwuma a, dɛn na ɛba?
• Bere bɛn na ɛsɛ sɛ mekyerɛw me duruyɛfo nkyɛn bere a edi hɔ?

Evans Syndrome yɛ tebea a ɛntaa nsi a ebia wontee ho asɛm da. Nsɛnkyerɛnne no betumi ayɛ nwonwa na ahaw adwene. Nea ɛrekɔ so ne nea ɛkyerɛ ase a wobɛte ase no betumi ayɛ adeyɛ a ɛyɛ hu kakra.

Ɛwom sɛ Evans Syndrome yɛ tebea a ɛkɔ so wɔ nkwa nna nyinaa mu de, nanso ɛnyɛ bere nyinaa na ɛte saa ara. Kɔ so kura anidaso a ɛne sɛ wo ho bɛtɔ wo, anyɛ yiye koraa no, ɛtɔ mmere bi a. Ɛmfa ho sɛnea wote nka no, w’aduruyɛfo kuw no bɛba hɔ de ɔhwɛ a wuhia ama wo.

Nkrasɛm a Etwa To a Wɔde Kɔ Fie

Okay, enti momma yɛnkae wo nneɛma a ɛho hia paa a yɛaka ho asɛm no bi.

• Dɛn ne Evans Syndrome?Yare a ɛntaa nsi a w’ankasa nipadua mu tumi a ɛko tia nyarewa no tow hyɛ w’ankasa wo mogya mu nkwammoaa so.
• Eyi betumi ama mogya mu nkwammoaa kɔkɔɔ ( mogya a ɛtɔ kɔ nipadua mu ), mogya nkwammoaa (thrombocytopenia), ne ebia neutrophils (neutropenia) so atew .
• Nsɛnkyerɛnne te sɛ ɔbrɛ dodo, honam ani hwɛbea, akisikuru a ɛnyɛ den, mogya a ɛtaa tu, ne ɔyare mmoawa a ɛtaa ba no betumi aba.
• Ɛwom sɛ wonni eyi ano aduru koraa de, nanso wobetumi de ayaresa asiw sɛnkyerɛnne ahorow no so .
• Ɛho hia yiye sɛ wubedi nnuruyɛfo afotu akyi daa na wohwɛ yare no ho sɛnkyerɛnne ahorow so.
• Ɛnyɛ wo nko ara. Wo nnuruyɛfo ne w’adɔfo bɛboa wo. Ɛho hia paa nso sɛ yɛbɛkɔ so anya adwempa.

Mewɔ anidaso sɛ saa nsɛm yi bɛboa wo. Sɛ wowɔ nsɛmmisa bi a, ntwentwɛn wo nan ase sɛ wo ne wo duruyɛfo bɛkasa.

Evans syndrome, yare a nipadua no tumi ko tia nyarewa, cytopenia, mogya a ɛtɔ kɔ nipadua mu, thrombocytopenia, neutropenia, mogya mu yare