So wo mogya mu nkwammoaa kɔkɔɔ no ayɛ kɛse? (Macrocytosis) - Momma yɛnhwehwɛ eyi ho nsɛm!

So woahwɛ mogya mu nhwehwɛmu amanneɛbɔ bi na woahu sɛ wo mogya mu nkwammoaa kɔkɔɔ no sõ sen sɛnea ɛte daa (mogya mu nkwammoaa kɔkɔɔ a ayɛ kɛse) pɛn? Anaasɛ wo duruyɛfo aka tebea bi a wɔfrɛ no “Macrocytosis” ho asɛm akyerɛ wo pɛn? Ebia eyi bɛyɛ te sɛ nea ɛyɛ hu kakra, nanso mma ɛnhaw wo. Macrocytosis nyɛ yareɛ, ɛyɛ nsakraeɛ a ɛba mogya mu nkwammoaa kɔkɔɔ mu ara kwa.

Dɛn ne Macrocytosis?

Sɛ yɛbɛka no tiawa a, Macrocytosis kyerɛ sɛ wo mogya mu nkwammoaa kɔkɔɔ no sõ sen sɛnea ɛte daa. Wommu eyi sɛ yare, nanso ebetumi ayɛ biribi a ɛnteɛ wɔ yɛn nipadua mu ho sɛnkyerɛnne. Wohu eyi bere a woanya mogya dodow a edi mũ (CBC)/ Mogya dodow a edi mũ ( FBC ). Mpɛn pii no, nnuruyɛfo yɛ saa `CBC` sɔhwɛ yi de hwɛ sɛnea yɛn nipadua mu nkwammoaa reyɛ adwuma ne sɛnea ɛwɔ apɔwmuden.

`CBC` amanneɛbɔ no wɔ botaeɛ a wɔfrɛ no `MCV (Mean Corpuscular Volume)`. Eyi yɛ nea wɔde susuw sɛnea wo mogya mu nkwammoaa kɔkɔɔ no kɛse te. Sɛ ɔpanyin bi `MCV` bo boro femtoliters 100 (`100 fL`) a, yɛfrɛ saa tebea no Macrocytosis.

Mpɛn pii no, eyi nyɛ ɔhaw a anibere wom. Nanso, ɛtɔ mmere bi a, ebia mogya mu nkwammoaa kɔkɔɔ a ayɛ kɛse yi rennya aduannuru a ehia no. Afei, saa nkwammoaa no ntumi nyɛ wɔn adwuma titiriw, a ɛne sɛ wɔde mframa pa bɛkɔ nipadua no mu nyinaa. Wɔfrɛ saa tebea yi `Macrocytic Anemia` . Sɛ wɔansa `Macrocytic Anemia` yiye a, ebetumi de akwahosan ho haw a emu yɛ den aba.

Saa tebea yi abu so dɛn?

Sɛ yɛbɛka no tiawa a, wiase nnipa dodow 2% kosi 4% na wɔwɔ Macrocytosis. Saa nnipa yi mu dodow no ara, bɛyɛ 60%, wɔ Macrocytosis a mogya a ɛtɔ kɔ nipadua mu ka ho.

Nanso, macrocytosis a mogya nnim abu so kɛse wɔ mmofra nkumaa ne wɔn a wɔn mfe akɔ anim mu.

Dɛn ne Macrocytosis ho sɛnkyerɛnne ahorow?

Mpɛn pii no, macrocytosis ho sɛnkyerɛnne biako pɛ ne MCV a ɛkɔ soro wɔ CBC amanneɛbɔ no mu. Nea eyi kyerɛ ara ne sɛ wo mogya mu nkwammoaa kɔkɔɔ no sõ. Sɛ sɛnkyerɛnne ahorow ba a, ɛne nea ɛde mogya mu nkwammoaa kɔkɔɔ a ayɛ kɛse no ba no wɔ abusuabɔ.

Sɛ nhwɛso no, sɛ wowɔ `Macrocytic Anemia` a, wubetumi anya sɛnkyerɛnne te sɛ mmerɛwyɛ , ɔbrɛ, ne honam ani a ɛyɛ mmerɛw , a ɛyɛ mogya a ɛtɔ kɔ nipadua mu ho sɛnkyerɛnne a ɛtaa ba. Afei nso, sɛ nea ɛde ba ne aduannuru a wonnya nni a, ebia wubehu sɛnkyerɛnne ahorow te sɛ akisikuru, nkae a ɛyɛ den, ne sɛnea wobɛkari pɛ .

Ɛno kyerɛ sɛ, esiane sɛ nneɛma pii na ɛde macrocytosis ba nti, sɛnkyerɛnne ahorow no nso betumi ayɛ soronko.

Dɛn ne nneɛma a ɛde macrocytosis ba?

Wɔyɛ mogya mu nkwammoaa wɔ yɛn nnompe mu. Enti, ɔhaw ahorow a ɛwɔ mogya mu nkwammoaa kɔkɔɔ a wɔyɛ wɔ nnompe mu ntini yi mu ne ɔhaw ahorow a ɛwɔ mogya mu nkwammoaa kɔkɔɔ nhyehyɛe mu no betumi ama Macrocytosis aba. Ɛtɔ da bi a, sɛ wowɔ mogya mu nkwammoaa kɔkɔɔ a ennyinii, a wɔfrɛ no `reticulocytes`, pii dodo wɔ wo mogya mu a, ɛnde `MCV` bo nso betumi akɔ soro. Eyi te saa efisɛ saa `reticulocytes` yi sõ sen mogya mu nkwammoaa kɔkɔɔ a ɛho akokwaw.

Nneɛma atitiriw a ɛde macrocytosis ba no bi ne:

Aduan pa a wonnya nni

Aduannuru te sɛ vitamin B12 ne folate (vitamin B9) ho hia ma yɛn nipadua na ama yɛatumi ayɛ mogya mu nkwammoaa kɔkɔɔ a ɛte apɔw. Sɛ woannya saa aduannuru yi nnɔɔso amfi aduan a wudi mu, anaasɛ wo nipadua ntumi nnye esiane yare bi nti a, wo mogya mu nkwammoaa kɔkɔɔ no rennyin yiye. Vitamin B12 ne folate a enni nipadua mu no betumi de tebea bi a wɔfrɛ no `Macrocytic Anemia` aba. Sɛ nhwɛso no, nnipa binom nni nhabannuru ne nnuaba a ɛyɛ ahabammono sɛnea ɛsɛ. Eyi betumi ama folate ho ayɛ no na. Afei nso, nnipa a wonni vegan koraa no betumi anya vitamin B12 a wonni.

Nnuru bi

Nnuru ahorow nso betumi de macrocytosis aba. Eyinom mu nea abu so kɛse ne hydroxyurea, aduru bi a wɔde sa sickle cell yare, nnuru ahorow a wɔde sa kokoram, ne nnuru a ekum ɔyare mmoawa (ART) a wɔde sa HIV yare no. Sɛ worenom nnuru yi bi a, ɛda adi sɛ wo duruyɛfo no behu.

Nsã a wɔnom

Nsã a wɔnom boro so nso yɛ ade titiriw a ɛde Macrocytosis ba. Nsã ma nipadua no tumi twetwe aduannuru, titiriw nea ehia na ama mogya mu nkwammoaa kɔkɔɔ a ɛte apɔw no ase.

Mmɛn mu yare

Macrocytosis nso betumi ayɛ mmerɛbo mu yare ho sɛnkyerɛnne. Mpɛn pii no, mmerɛbo mu yare ne nsanom wɔ abusuabɔ, nanso ɛnyɛ bere nyinaa. Nanso, mmerɛbo mu yare nso betumi aba esiane nneɛma afoforo nti.

mogya a ɛtɔ kɔ mogya mu a ɛma mogya tu

Wɔ tebea bi a wɔfrɛ no ``Hemolytic anemia'' mu no, wo mogya mu nkwammoaa kɔkɔɔ no wuwu ntɛm esiane tebea bi a ɛwɔ ase nti. Sɛ eyi ba a, wo nipadua no gyae ``reticulocytes,'' (mogya mu nkwammoaa kɔkɔɔ a ennyinii) kɔ mogya no mu de yɛ nea ɛho yɛ na no. Saa mogya mu nkwammoaa kɔkɔɔ a ennyinii yi ntumi mfa mframa pa nkɔ te sɛ mogya mu nkwammoaa kɔkɔɔ a ɛho akokwaw.

Mogya a ɛtɔ dodo

Sɛ wohwere mogya pii, sɛ́ ebia efi akwanhyia, oprehyɛn, anaa biribi foforo mu a, wo nipadua no de reticulocytes bɛka wo mogya ho de asiesie nea woahwere no. Sɛnea ɛte wɔ mogya a ɛtɔ mogya mu a ɛma mogya tu mu no, nkwammoaa a wonnyinii no hyɛn mogya no mu ntɛm.

Myelodysplastic yare a ɛma obi ho yɛ hyew

Eyi yɛ kokoram bi a ɛba nnompe mu ntini mu. Saa tebea yi mma nnompe mu ntini no ntumi nnya mogya mu nkwammoaa kɔkɔɔ a ɛte apɔw.

Hypothyroidism a ɛma mogya tu

Macrocytosis betumi aba nso wɔ nnipa a wɔwɔ hypothyroidism, thyroid ntini a ɛnyɛ adwuma yiye no so. Ebetumi aba bere a mogya a ɛtɔ kɔ nipadua mu no anaasɛ enni mu.

Ɛtɔ mmere bi a, wontumi nhu nea ɛde macrocytosis ba pefee biara, titiriw sɛ wowɔ macrocytosis a mogya nnim nkutoo a.

Wobɛyɛ dɛn ahu sɛ wowɔ macrocytosis anaa?

Sɛnea yɛadi kan aka no, macrocytosis yɛ asɛmfua a ɛkyerɛ mogya mu nkwammoaa kɔkɔɔ a ayɛ kɛse, na ɛnyɛ aban yare. Sɛ MCV bo a ɛwɔ wo CBC amanneɛbɔ so no boro 100 fL a, ɛkyerɛ sɛ wo mogya mu nkwammoaa kɔkɔɔ no sõ sen sɛnea ɛte daa.

Ɛtɔ mmere bi a nnuruyɛfo betumi agyina sɛnea tebea no mu yɛ den so asusuw nea ɛde Macrocytosis ba no ho. Sɛ nhwɛso no, sɛ MCV no dɔɔso yiye (bɛyɛ 110 – 115 fL) a, ebetumi ayɛ macrocytic anemia a emu yɛ den kɛse ho sɛnkyerɛnne, te sɛ megaloblastic anemia.

Sɔhwɛ ahorow a wɔyɛ de hu nea ɛde macrocytosis ba

Sɛ wo duruyɛfo no dwen wo mogya mu nkwammoaa kɔkɔɔ a ayɛ kɛse no ho a, obebisa wo nsɛm de ahu nea ɛde ba. Ebia obebisa w’ayaresa ho abakɔsɛm, nnuru a wonom, w’aduan, ne nsa a wonom ho asɛm . Nea ɛka ho no, obetumi ayɛ sɔhwɛ afoforo bi nso:

• Mogya a wɔde gu nipadua no akyi:Nea ɛka eyi ho ne sɛ wobɛfa wo mogya bi na woahwɛ wɔ afiri a wɔde hwɛ nneɛma nketenkete mu ahwɛ sɛ ebia nneɛma bi wɔ hɔ a ɛnteɛ a ebetumi de Macrocytosis aba, te sɛ ɔhaw ahorow a ɛfa mogya mu nkwammoaa kɔkɔɔ nyin ho anaa.
• Vitamin B12 ne folate dodow ho nhwehwɛmu: Sɛ vitamin B12 anaa folate dodow a ɛwɔ mogya mu no sua a, ɛkyerɛ sɛ aduannuru bi a enni hɔ a ennya aduannuru a ehia na ama mogya mu nkwammoaa kɔkɔɔ ayɛ no yiye.
• Reticulocyte dodow: Saa nhwehwɛmu yi susuw mogya mu nkwammoaa kɔkɔɔ a ennyinii dodow a ɛwɔ wo mogya mu. Eyi betumi aboa ma woahu sɛ ebia eyi na ɛde wo MCV a ɛkɔ soro no ba anaa.
• Mmerɛbo dwumadi ho sɔhwɛ: Eyi sɔ sɛnea wo mmerɛbo reyɛ adwuma yiye na ama aduannuru a ehia na ama woanya mogya mu nkwammoaa kɔkɔɔ a ɛte apɔw no hwɛ.
• Bone marrow biopsy: Sɛ wo duruyɛfo susuw sɛ wowɔ tebea bi a ɛresiw wo mogya mu nkwammoaa kɔkɔɔ a wɔyɛ no kwan a, wobetumi ayɛ nhwehwɛmu yi. Nea ɛka eyi ho ne sɛ wobɛfa wo nnompe mu ntini ketewaa bi na wode afiri a wɔde hwɛ nneɛma nketenkete ahwɛ nkwammoaa no mu ahwɛ sɛ ebia nneɛma bi a ɛnteɛ wɔ hɔ anaa.

Ɔkwan bɛn so na wɔsa Macrocytosis?

Sɛ wunni mogya a ɛtɔ kɔ wo mu ho sɛnkyerɛnne biara, na nea efii wo nhwehwɛmu mu bae no nkyerɛ sɛ biribi foforo biara nni hɔ a ɛnteɛ a, ebia wunhia ayaresa biara. Sɛ ɛnte saa a, ayaresa no begyina nea ɛde wo mogya mu nkwammoaa kɔkɔɔ dodow a ɛkɔ soro no so.

• Sɛ aduannuru a wunni na ɛde wo macrocytosis ba a, ebia ebehia sɛ wosakra w’aduan anaasɛ wonom vitamin a wɔde ma .
• Sɛ ɔhaw no fi aduru bi a worenom ho a, ebia wo duruyɛfo betumi asesa dodow a wode ma no anaasɛ ɔbɛkyerɛw wo aduru foforo .
• Sɛ mogya a ɛtɔ wo mu denneennen ka macrocytosis ho a, ebia ebehia sɛ wɔma wo mogya .

Ade a ɛho hia sen biara ne sɛ wubedi ayaresa nhyehyɛe a wo duruyɛfo de ama wo no akyi pɛpɛɛpɛ, a nea ɛde wo macrocytosis no ba mfa ho.

So wobetumi asa Macrocytosis yare?

Mpɛn pii no, macrocytosis bɛdan ne ho bere a wɔasa nea ɛde ba no. Bisa wo duruyɛfo sɛnea ayaresa no bɛka w’akwahosan.

Ɔkwan bɛn so na wɔbɛtew asiane a ɛwɔ macrocytosis mu no so?

Ebia yɛrentumi nsiw biribiara a ebetumi ama macrocytosis aba no ano. Nanso, yebetumi atew asiane a ɛwɔ hɔ no so denam suban pa a yebegye atom no so. Nhwɛsoɔ:

• Sɛ wode nnuan a vitamin B12 ne folate pii wom – mpataa, nufusu mu nneɛma, nkesua , nhaban momono, ne aburow a wɔahyɛ no den – ka w’aduan ho a, ebetumi atew asiane a ɛwɔ hɔ sɛ wubenya macrocytic anemia no so.
• Ɛho hia yiye sɛ wɔbɛto nsa a wɔnom ano hye .
• Afei nso, ntwa mogya mu nhwehwɛmu a wɔyɛ no afe biara no so. Wɔtaa hu macrocytosis wɔ akwanhyia mu bere a wɔreyɛ mogya mu nhwehwɛmu daa no. Sɛ wohu yare no ntɛm na wɔsa no a, ebetumi asiw tebea no ano.

Sɛ wɔannya macrocytosis a wɔansa a, dɛn na ɛba?

Oduruyɛfo nkutoo na obetumi ahu sɛ ebia wo Macrocytosis no yɛ biribi a ɛsɛ sɛ wohaw wo ho wɔ ho anaa. Sɛ wowɔ Macrocytosis a mogya mmoroso ka ho a, ɛho hia sɛ wohwehwɛ ayaresa. Sɛ wɔansa Macrocytic Anemia a, ebetumi de akwahosan ho haw ahorow a emu yɛ den aba.

Dɛn na ɛsɛ sɛ mibisa oduruyɛfo no?

Sɛ wuhu sɛ wo mogya mu nkwammoaa kɔkɔɔ no sõ sen sɛnea ɛte daa a, di wo duruyɛfo afotu a ɛfa nea ɛsɛ sɛ woyɛ ho no akyi. Ebia wobɛpɛ sɛ wubisa nsɛm te sɛ:

• So ɛsɛ sɛ mehaw me ho wɔ me MCV a ɛkorɔn no ho?
• Nhwehwɛmu bɛn na ebehia na ama mahu nea ɛde macrocytosis ba?
• So ebehia sɛ mesa nea ɛde me mogya mu nkwammoaa kɔkɔɔ a ayɛ kɛse no?
• Asetra mu nsakrae bɛn na metumi ayɛ de adi Macrocytosis tebea yi ho dwuma?

Awiei koraa no, kae (Take-Home Message) .

Ɛnyɛ bere nyinaa na macrocytosis anaa MCV a ɛkɔ soro no yɛ ade a ɛhaw adwene. Enti sɛ wo CBC amanneɛbɔ no kyerɛ saa gyinapɛn ahorow yi a, mma wo ho nnyɛ wo hu. Nya wo duruyɛfo akwankyerɛ wɔ sɛnea wobɛkyerɛ nea efi mu ba no ase ho. Ebia wo duruyɛfo bɛkyerɛ sɛ ɔnyɛ nsakrae wɔ w’aduan mu anaasɛ fa vitamin a wode bɛma wo no, a egyina nea ebefi mu aba so. Nsuro sɛ wubebisa sɛnea w’ayaresa no bɛka wo mogya mu nkwammoaa ne w’akwahosan nyinaa. Apɔwmuden a wobɛkɔ so atra hɔ no ne ade a ɛho hia sen biara!