So ɔhaw kɛse bi wɔ wo nipadua mu? Momma yensua Waterhouse-Friderichsen Syndrome ho ade!

So woate pɛn sɛ ntini nketenkete abien a ɛwɔ nipadua no mu gyae adwumayɛ, na ebetumi anya w’asetra so nkɛntɛnso kɛse? Ɛnnɛ yɛrebɛka tebea a ɛyɛ hu paa a ɛte saa ho asɛm, na sɛ wɔansa no ntɛm a, ebetumi akum obi. Wɔfrɛ eyi sɛ Waterhouse-Friderichsen Syndrome. Ɛwom sɛ ebia edin no bɛyɛ te sɛ nea ɛware kakra de, nanso momma yɛnka nea ɛyɛ, nea enti a ɛba, ne sɛnea yebetumi atra ase ho asɛm kɛkɛ.

Dɛn ne Waterhouse-Friderichsen Yare yi?

Sɛ yɛbɛka no tiawa a, Waterhouse-Friderichsen Syndrome (WFS) yɛ tebea a emu yɛ den yiye. Nea ɛba ne sɛ wo adrenal glands , a ɛyɛ ntini nketewa abien a ɛwɔ w’asaabo atifi no, mogya tu (yɛfrɛ eyi `adrenal hemorrhage`) na saa ntini yi mu biako anaa abien no nyinaa gyae adwumayɛ. Mpɛn pii no, ɔyare mmoawa a emu yɛ den na ɛde eyi ba. Sɛ wɔansa saa adrenal ntini yi yare a, ɛkame ayɛ sɛ gyae hormone cortisol a ɛho hia ma yɛn nipadua no yɛ koraa. Eyi ne nea yɛfrɛ no adrenal crisis . Sɛ yɛbɛka no pɛpɛɛpɛ a, ɛyɛ asɛm a egye ntɛmpɛ!

Edin foforo bi wɔ hɔ a wɔde frɛ eyi, a ɛne ``hemorrhagic adrenalitis.'' Ɛno kyerɛ sɛ adrenal ntini no mogya tu na ɛyɛ hyew.

Saa tebea yi abu so dɛn?

Nokwarem no, Waterhouse-Friderickson yare no ho yɛ na koraa . Mpɛn pii no, afunu mu nhwehwɛmu hu sɛ saa tebea yi na ɛma nnipa a wowuwu no mu bɛyɛ 1% pɛ. Eyi kyerɛ sɛ ɛnyɛ yare a ɛka obiara, nanso sɛ ɛba a, ɛyɛ hu paa.

Dɛn ne yare yi ho sɛnkyerɛnne?

Fa no sɛ, mpofirim ara wunyaa mmoawa anaa mmoawa bi na wunyaa WFS tebea yi. Afei wubetumi afi ase ada ɔyare mmoawa ho sɛnkyerɛnne adi mpofirim. Wunim nea ɛno yɛ?

• Merenya atiridiinini a emu yɛ den.
• Nipadua no te awɔw nka na ɛwosow (Chills).
• Me ti yɛ me yaw paa.
• Me deɛ, mɛfe, mɛfe.
• Ntini a ɛwɔ me nipadua mu no yɛ me yaw, titiriw wɔ mmeae te sɛ m’akyi, yafunu, ne me nan ase.
• Me nkwaa yɛɛ me yaw.
• Ɛtɔ da bi a, ebia adwenem naayɛ (syncope) bɛba.

Sɛ ɛnyɛ adrenal glands nko na mogya a ɛretu yi fi ase ka, na mmom nipadua no afã afoforo nso a, sɛnkyerɛnne afoforo betumi ada adi. Eyinom bi ne:

• Disseminated intravascular coagulation (DIC): Eyi te sɛ nea ɛyɛ den kakra, ɛnte saa? Sɛ yɛbɛka no tiawa a, ɛyɛ ɔhaw a ɛma mogya a ɛkɔ nipadua no nyinaa mu no kɔ so yɛ basabasa. Sɛ mogya tu wɔ baabi a, entumi nnyae mogya a ɛretu wɔ baabi foforo.
• Honam ani akisikuru:Ɛtɔ da bi a, wotumi pue wɔ honam ani sɛ nsensanee nketewa anaa nsensanee akɛse.
• Septic shock: Eyi yɛ tebea a mogya mmoroso kɔ fam wɔ ɔkwan a ɛyɛ hu so esiane ɔyare mmoawa nti, na ɛma nipadua no akwaa ahorow no nnya mogya a ɛdɔɔso. Eyi nso yɛ nea asiane wom kɛse.

Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ mogya tu wɔ adrenal gland mu?

WFS ne mogya a ɛtɔ kɔ adrenal mu, a ebia sɛnkyerɛnne afoforo bɛka ho:

• Yafunu mu yaw.
• Ɛyaw wɔ beae a ɛwɔ asen no atifi, mpampam (asen) ase.
• Malaise, atenka a ɛne sɛ ne ho nyɛ no dɛ.
• Ɔbrɛ a wɔyɛ.
• Akisikuru ne ɔfe.
• Ayamtuo.

Dɛn na ɛde eyi ba?

Mpɛn pii no, nea ɛde Waterhouse-Friderickson yare no ba titiriw ne mmoawa ne mmoawa a wɔde nyarewa ba (sepsis) . Sɛ yɛbɛka no pɛpɛɛpɛ a, ɔyare mmoawa bi hyɛn nipadua no mu na ɛtrɛw kɔ nipadua no mu nyinaa a wontumi nni so.

Mmoawa ahorow bi betumi ayɛ nea ɛyɛ mmerɛw sɛ wobenya eyi. Nhwɛso kakraa bi ni:

• `Pseudomonas a ɛyɛ aeruginosa`
• Meningococcus mmoawa: Eyi ne nea asiane wom sen biara a ebetumi de WFS aba.
• `Streptococcus ahurututu mu yare`
• `Haemophilus atiridiinini`
• `Escherichia coli (E. coli)`
• `Staphylococcus aureus a ɛyɛ ɔyare mmoawa`

Mmoawa afoforo pii betumi de eyi aba.

Afei nso, mmoawa ahorow bi betumi de eyi aba:

• Nkwammoaa a wɔfrɛ no Cytomegalovirus (CMV) .
• Parvovirus `(Parvovirus)`
• Epstein-Barr mmoawa a wɔde nyarewa ba
• Ebola mmoawa `(Ebola mmoawa yare)`
• Varicella-zoster virus (eyi na ɛde nyarewa te sɛ akisikuru ne akisikuru ba) .

Wɔ saa nyarewa yi akyi no, asiane afoforo bi wɔ hɔ a ebetumi ama obi anya WFS:

• Nnuru a ekum mogya a ɛtwetwe mogya a wɔde di dwuma. Eyinom ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no yɛ kɛse.
• Thrombocytopenia: Eyi kyerɛ sɛ mogya nkwammoaa (nkwaboaa a ɛboa ma mogya tu) dodow a ɛwɔ mogya no mu no so tew.
• Wɔasɛe adrenal ntini no wɔ ɔkwan bi so.

Hena na tebea yi ka no kɛse?

Waterhouse-Friderickson yare no taa nya mmofra nkumaa sen mpanyimfo . Enti, sɛ abofra kumaa bi nya yare no ho sɛnkyerɛnne te sɛ atiridiinini ne nipadua mu yaw a, ɛsɛ sɛ wohwɛ yiye paa.

Nsɛnnennen bɛn na eyi betumi de aba?

Eyi ne ade a ɛho hia sen biara. Sɛ wɔansa no ntɛm na wɔansa no yiye a, Waterhouse-Friderickson yare no di awu. Ɛno kyerɛ sɛ ebetumi de nkwa ato asiane mu. Enti ɛsɛ sɛ wobu eyi sɛ asɛm a egye ntɛmpɛ.

Ɔkwan bɛn so na wohu yare yi?

Sɛ wubetumi ahu yare yi a, akyinnye biara nni ho sɛ wuhia oduruyɛfo mmoa. Oduruyɛfo no bebisa wo wo yare no ho sɛnkyerɛnne, abisa wo nyarewa a woadi kan anya no ho asɛm, na afei wahwɛ wo nipadua mu.

Nanso WFS a wobehu no betumi ayɛ den kakra, efisɛ ne sɛnkyerɛnne ahorow no te sɛ septic shock de no ara pɛ . Enti, sɛnea ɛbɛyɛ a oduruyɛfo no bɛkyerɛ sɛ ɛyɛ WFS anaa no, ɔbɛhyɛ sɛ wɔnyɛ nhwehwɛmu ahorow.

Nhwehwɛmu bɛn na wɔde hu yare no?

Nea ɛbɛyɛ na oduruyɛfo no ahu sɛ ɔyare bi wɔ hɔ anaa no, obetumi ayɛ nhwehwɛmu ahorow a edidi so yi:

Mfoninitwa sɔhwɛ ahorow

• Wobetumi ayɛ ultrasound scan anaa CT (computed tomography) scan de ahwɛ sɛ mogya aboaboa ano wɔ adrenal glands no mu anaa. Saa scan ahorow yi twa nipadua no mu mfonini, enti wotumi hu mmeae a mogya retu no pefee.

Mogya mu nhwehwɛmu

• Mogya mu nhwehwɛmu betumi ahu sɛ wowɔ ɔyare mmoawa bi anaa. Nea ɛka eyi ho ne sɛ wubeyi ade ketewaa bi afi ntini bi a ɛwɔ wo nsa mu mu, agye mogya kakraa bi, na wode afiri a wɔde hwɛ nneɛma nketenkete ahwɛ. Eyi bɛhwehwɛ sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi anya ɔyare mmoawa.

Meningococcus mmoawa ho nhwehwɛmu

Sɛ oduruyɛfo no susuw sɛ nea ɛde ba ne meningococcus mmoawa a, ɛnde ebia wɔbɛyɛ nhwehwɛmu ahorow te sɛ eyinom:

• Spinal tap / lumbar puncture: Eyi hwehwɛ sɛ wode ade teateaa bi bɛhyɛ w’akyi ase, wɔ akyi berɛmo abien ntam, na woafa akyi berɛmo mu nsu kakraa bi. Ebia eyi bɛyɛ te sɛ nea ɛyɛ hu, nanso nnuruyɛfo de ahwɛyiye yɛ.
• Skin biopsy: Sɛ wowɔ akuru bi wɔ wo honam ani a, wobeyi were ketewaa bi afi akuru no mu na wɔahwɛ mu.
• Gram stain test: Wɔfa nhwɛsode bi fi baabi a wosusuw sɛ ɛwɔ hɔ (te sɛ kuru) de hwehwɛ mmoawa.
• Nsuo mu nhwehwɛmu: Wɔbɛka akyerɛ wo sɛ fa nsuo gu ade soronko bi mu. Afei wɔbɛsɔ nsuo a wɔde yɛ nhwɛsoɔ no ahwɛ sɛ ebia ɔyareɛ ho sɛnkyerɛnne bi wɔ hɔ anaa.

Adrenal ahokyere a emu yɛ den ho sɔhwɛ ahorow

Saa nhwehwɛmu ahorow yi boa ma wuhu sɛ ebia worehyia adrenal crisis , tebea a adrenal glands no ntumi nyɛ adwuma yiye:

• Adrenocorticotropic hormone (ACTH) stimulation test: Wɔ sɔhwɛ yi mu no, wo duruyɛfo de hormone bi a wɔfrɛ no ACTH ketewaa bi ma wo. Afei, simma 30 kosi 60 akyi no, wɔfa mogya de hwɛ sɛnea wo adrenal ntini ahorow no yɛ wɔn ade wɔ ACTH no ho. Eyi yɛ sɔhwɛ a ɛkyerɛ sɛnea wo adrenal glands no reyɛ adwuma yiye.
• Mogya mu asikre mu nhwehwɛmu:Wɔfa mogya kakraa bi na wɔsusuw asikre (glucose) dodow a ɛwɔ mu. Asikre dodow betumi akɔ fam bere a adrenal haw bi wɔ hɔ no.
• Cortisol nhwehwɛmu: Wɔfa wo mogya, wo nsu, wo nnompe, anaa eyinom mu abien anaa abiɛsa a wɔaka abom de hwɛ sɛnea wo adrenal glands no reyɛ cortisol dodow.
• pH mogya mu nhwehwɛmu: Wɔfa mogya bi na wɔsusuw ne acid-base dodow (pH). Wobetumi de mogya mu mframa a ɛwɔ ntini mu (ABG) mu nhwehwɛmu anaa electrolyte panel ayɛ eyi. Mpɛn pii no, ɛsɛ sɛ yɛn mogya mu pH yɛ 7.35 kosi 7.45.
• Potassium mogya mu nhwehwɛmu: Mogya mu nhwehwɛmu a wɔde susuw potassium dodow a ɛwɔ wo mogya mu. Potassium yɛ aduannuru a ɛboa ma yɛn ntini ne yɛn ntini yɛ adwuma yiye. Saa dodow yi betumi asesa bere a adrenal ahokyere bi wɔ hɔ no.
• Sodium mogya mu nhwehwɛmu: Mogya mu nhwehwɛmu kyerɛ sodium dodow a ɛwɔ wo mogya mu. Sodium nso ho hia na ama wo ntini ne wo ntini ahorow ayɛ adwuma yiye. Saa dodow yi nso betumi ayɛ soronko.

Ɔkwan bɛn so na wɔsa eyi?

Sɛ wowɔ WFS a, ebia wowɔ sepsis nso . Enti, ade a edi kan a nnuruyɛfo bɛyɛ ne sɛ wobefi ase anom nnuru a ekum ɔyare mmoawa ntɛm ara bere a wɔreyɛ nhwehwɛmu de ahu nea ɛde WFS no bae ankasa no. Wɔbɛhwɛ wo electrolyte (nkyene) ne nsu dodow nso.

Sɛ wotumi di sepsis ho sɛnkyerɛnne ahorow so wie a, nnuruyɛfo befi ase ama wo nnuru a wɔfrɛ no glucocorticoids ne mineralocorticoids . Eyinom yɛ steroid hormone ahorow. Glucocorticoids yɛ adwuma ma ɔfe a ɛwɔ nipadua no mu no so tew. Mineralocorticoids yɛ adwuma de hwɛ ma wo nipadua mu nkyene ne nsu dodow yɛ yiye. Sɛ yɛbɛka no tiawa a, ɛte sɛ nea wɔma wo hormone ahorow a ɛsɛ sɛ wo adrenal glands no yɛ, nanso ɛnyɛ saa.

Ebia wubehia mogya anaa ɔkwan bi a wɔfrɛ no angioembolization . Nea ɛka eyi ho ne sɛ wɔde angiogram ne mogya a ɛtwetwe (embolization) bedi dwuma de ahu ntini a ɛde mogya kɔ adrenal ntini no mu no na wosiw ano. Wɔyɛ eyi na ama mogya no agyae.

Nea ɛho hia sen biara no, wɔ WFS akyi no, ebehia sɛ nnipa pii nom nnuru foforo a ɛma hormone wɔ wɔn nkwa nna nyinaa mu , efisɛ sɛ adrenal glands no sɛe pɛ a, ebia wɔrentumi nyɛ hormone yiye bio.

Me ho bɛtɔ me ntɛm dɛn wɔ ayaresa akyi?

Nnipa dodow no ara fi ase te nka wɔ dapɛn biako anaa abien akyi bere a wɔafi ayaresa ase no. Nanso, bere a wo ho atɔ wo koraa mpo no, ebia woda so ara wɔ honam fam anaa adwene mu haw ahorow bi asram pii, anaa mfe pii mpo. Nhwɛsoɔ:

• Aduan no nyɛ dɛ.
• Ɔbrɛ paa.
• Ɛyɛ den sɛ wobɛda (dae a wontumi nna).
• Su a ɛne sɛ obi bɛyare ntɛmntɛm.
• Brɛ.
• Hahaahayɔ.

Enti, ɛho hia sɛ yɛkae sɛ ebia ebegye bere kakra ansa na ne ho atɔ no koraa.

Sɛ wunya saa yare yi a, dɛn na wubetumi ahwɛ kwan?

Sɛnea yɛadi kan aka no, sɛ wɔansa a, WFS yɛ tebea a edi awu. Akyinnye biara nni ho.

Nanso, sɛ wɔsa wɔn yare ntɛm, wɔ ɔkwan a ɛfata so na wɔsan siesie wɔn a, nnipa dodow no ara a wɔwɔ WFS no ho tɔ wɔn. Nanso, ebia wubehia ayaresa a emu yɛ den, na nkɛntɛnso a WFS de ba no betumi atra hɔ asram pii, mfe pii mpo. Enti, ɛnyɛ biribi a ɛsɛ sɛ wobu no adewa.

So wobetumi asiw tebea yi ano?

Nneɛma pii wɔ hɔ a wubetumi ayɛ de atew asiane a ɛwɔ hɔ sɛ wubenya Waterhouse-Friderickson yare no so:

• Sɛ wohohoro wo nsa daa na wohohoro wo ho yiye a, ebetumi aboa ma woasiw nyarewa ano. Eyi yɛ ade a ɛnyɛ den koraa, nanso ebetumi agye wo afi nyarewa pii mu.
• Meningococcal bacteria vaccine a wobenya no ho hia mmofra titiriw.
• Sɛ wususuw sɛ wowɔ ɔyare bi a, hwehwɛ ayaresa ntɛm ara. Mma w’ani ngu atiridii anaa ɔfe kakra so.

Wobɛyɛ dɛn ahwɛ wo ho bere a wo ho retɔ wo no?

Bere a wo ho retɔ wo no, ɛsɛ sɛ wo ne wo duruyɛfo bom yɛ nhyehyɛe a ɛbɛma woasan asiesie wo ho a ɛfata, ahobammɔ wom, na eye ma wo. Ebia nneɛma te sɛ:

• Nya ahomegye pii. Nipadua ne adwene nyinaa hia ahomegye.
• Aduan a ɛkari pɛ a ɛbɛboa wo ma woasan anya ahoɔden a wubedi akyi no yɛ adwene pa. Sɛ wubetumi anya afotu afi aduannuru ho ɔbenfo hɔ wɔ eyi ho a, ɛbɛyɛ papa.
• Fa botae nketenkete sisi w’ani so. Sɛ nhwɛso no, sɛ wobɛsɔre atra mpa so, wobɛsɔre gyina hɔ, wo nkutoo wubesiesie wo ho, woguare, wo nantew kwan tiaa bi, woforo antweri.
• Sɛ wo ne w’abusua, wo nnamfo, anaa oduruyɛfo bi bɛka wo nkate ho asɛm a, ɛho hia wɔ mmere a emu yɛ den yi mu.
• Yɛ apɔw-mu-teɛteɛ bere a wowɔ ahoɔden ne ahoɔden no. Fi ase nkakrankakra na teɛteɛ w’apɔw mu sɛnea wo duruyɛfo akwankyerɛ kyerɛ.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn? / Bere bɛn na ɛsɛ sɛ mekɔ baabi a wɔhwɛ wɔn a wɔwɔ tebea a egye ntɛmpɛ mu?

Sɛ woda so ara ho nyɛ wo den wɔ ayaresa akyi, anaasɛ ɛyɛ den ma wo sɛ wubedu wo botae ahorow a wode bɛsan asiesie wo ho no ho a, hwɛ hu sɛ wo ne wo duruyɛfo bɛkasa.

WFS yɛ tebea a emu yɛ den a sɛ wɔansa a, ebetumi akum obi. Sɛ wowɔ WFS ho sɛnkyerɛnne biara, sɛ nhwɛso no, ɔyare mmoawa a ɛreyɛ kɛse a ɛnkɔ a, ɛnde ɛsɛ sɛ wokɔ baabi a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ (ETU) ntɛm ara.Ɛnyɛ papa sɛ wode eyi bɛto nkyɛn.

Nsɛm bɛn na ɛsɛ sɛ wubisa wo duruyɛfo?

Sɛ wuhu sɛ wowɔ WFS a, ebia wubenya nsɛmmisa pii. Nsuro, bisa wo duruyɛfo nsɛm te sɛ eyinom na ama w’adwenem naayɛ no afi hɔ:

• Wobɛyɛ dɛn ahu sɛ mewɔ Waterhouse-Friderickson yare no?
• Sɛ minni Waterhouse-Friderickson syndrome a, tebea foforo bɛn na metumi anya?
• Dɛn na ɛde me Waterhouse-Friderickson yare no ba?
• So ɛsɛ sɛ wɔyɛ me oprehyɛn de siesie me adrenal glands?
• Wususuw sɛ me ho bɛtɔ me koraa?
• So ebehia sɛ menom hormone afoforo?
• Bere tenten ahe na ɛsɛ sɛ menom hormone afoforo?

Enti, nneɛma bɛn na ɛho hia paa a ɛsɛ sɛ yɛkae fi eyi mu?

Waterhouse-Friderichsen syndrome (WFS) yɛ tebea a emu yɛ den yiye a ɛsɛ sɛ wɔde kɔ ayaresabea ntɛm ara. Sɛ wowɔ saa sɛnkyerɛnne yi bi, anaasɛ wowɔ ɔyare mmoawa bi a ɛnnyɛ yiye a, ɛho hia sɛ wokɔ baabi a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu ntɛm ara sɛnea wubetumi.

Di ayaresa ho akwankyerɛ a wo duruyɛfo de ama wo nyinaa akyi pɛpɛɛpɛ. Ɛno nkutoo na wubetumi adi WFS tebea yi so na wo ho atɔ wo ntɛmntɛm sɛnea wubetumi. Kae sɛ ayaresa ntɛm betumi agye obi nkwa! Afei nso, ɛho hia paa sɛ wohwɛ wo ho yiye bere a wo ho retɔ wo no.

` Waterhouse-Friderichsen syndrome, adrenal ntini, cortisol, sepsis, ɔyare mmoawa, ɔhwɛ a egye ntɛmpɛ, hormone