Ðe wò ʋumenugbagbevi ɣiwo dzi ɖe kpɔtɔ afɔkutɔea? Ðe ema nye agranulocytosis? Mina míaƒo nu tso eŋu!

Ðe nèdzea dɔ ɣesiaɣia? Ðe nèsena le ɖokuiwò me be yegbɔdzɔ eye ɖeɖi te ŋuwò hena ɣeyiɣi kpui aɖe gɔ̃ hã? Ɣeaɖewoɣi la, esia ate ŋu atso wò ŋutilã ƒe ametakpɔnu siwo nye neutrophils, si nye ʋumenugbagbevi ɣi ƒomevi aɖe, ƒe ɖiɖi si me afɔku le gbɔ. Egbea míele nu ƒom tso dɔléle sesẽ aɖe si woate ŋu ada si woyɔna be agranulocytosis ŋu . Mègatsi dzi o, ele vevie be nànya esia.

Nuka tututue nye agranulocytosis?

Kpuie ko la, Agranulocytosis nye dɔléle si dea ame ƒe agbe afɔku me si me ʋumenugbagbevi ɣi siwo woyɔna be neutrophils ƒe xexlẽme dzi ɖena kpɔtɔna le míaƒe ŋutilã me va ɖoa agbɔsɔsɔ si bɔbɔ ŋutɔ. Ènya be ʋumenugbagbevi ɣiwo le abe asrafowo ene le míaƒe dɔlélenutsiŋutete mea? Woawoe kpɔa mía ta tso dɔlékui siwo hea dɔléle vɛ me. Ne neutrophil siawo ƒe xexlẽme dzi ɖe kpɔtɔ la, míaƒe ŋutilã va te ŋu xɔa dɔlékuiwo bɔbɔe. Dɔlékui siwo le dzɔdzɔme nu megblẽa nu boo aɖeke na mí o gɔ̃ hã ate ŋu ana míadze dɔ. Bu eŋu kpɔ, ne asrafoha tɔxɛ aɖe si le míaƒe dukɔa ƒe asrafoha me bu zi ɖeka la, ɖe futɔ sue aɖe gɔ̃ hã manye kuxi gã aɖeke oa? Esia hã nye nu ma ke. Ŋkɔ "agranulocytosis" tso nya granulocytes me. Granulocytes hã nye ʋumenugbagbevi ɣi ƒomevi aɖe. Enzyme siwo tsrɔ̃a dɔlékuiwo le wo me. Granulocyte ƒomevi etɔ̃e li: Neutrophils , Eosinophils, kple Basophils . Neutrophils ye nye ʋumenugbagbevi ɣi siwo bɔ ɖe míaƒe ŋutilã me wu. Esia tae ɖɔktawo doa neutrophil ƒe agbɔsɔsɔ kpɔna be woakpɔ agranulocytosis. Woyɔa esia ɣeaɖewoɣi be granulocytopenia .

Vovototo kae le Neutropenia kple Agranulocytosis dome?

Wo ame evea siaa do ƒome kple neutrophils ƒe ɖiɖi. Gake agranulocytosis ye nye neutropenia ƒomevi si nu sẽ wu .

• Neutropenia nye nɔnɔme si me neutrophils siwo le ʋua me ƒe xexlẽme le ʋɛ wu alesi wòle dzɔdzɔmee. Wogblɔ be ʋumenugbagbeviɣidɔ le amesiwo ƒe ʋumenugbagbevi dzĩwo mede 1,500 o le ʋu microlitre (mL) ɖeka me.
• Agranulocytosis ye nye afɔɖeɖe mamlɛtɔ, si me afɔku le wu, esime neutrophil ƒe xexlẽme ɖiɖina wu 100 le ʋu microlitre ɖeka me. See? Esiae nye ahɔhɔ̃mekawo ƒe agbɔsɔsɔ si nu sẽ wu.

Ðe agranulocytosis ƒomevi aɖewo lia?

Ẽ, esia ate ŋu ava le mɔ vevi eve nu: 1. Agranulocytosis si ƒe dome wonyi:Domenyiŋusẽfianu ƒe dɔléle aɖe gbɔe esia tsona. Eyae nye be kuxi aɖe le domenyiŋusẽfianu siwo kpena ɖe míaƒe ŋutilã ŋu wòwɔa neutrophils ŋu. Nɔnɔme sia gblẽa nu le vidzĩwo kple ɖevi suewo ŋu wu. 2. Acquired agranulocytosis: Esia ate ŋu atso nu geɖe gbɔ. Ke hã, zi geɖe (anɔ abe ɣeyiɣi 70% ene!) la, atike aɖewo siwo míenona ƒe nugbegblẽ le ame ŋu gbɔe wòtsona. Esia ƒomevi bɔ ɖe ame tsitsiwo me wu.

Aleke gbegbee nɔnɔme sia bɔe?

Le nyateƒe me la, esia nye nɔnɔme si mebɔ kura o. Le mamã dedie nu la, ame abe adre ene le ame akpe alafa ɖesiaɖe me xɔa nɔnɔme sia ƒe sia ƒe. Eyata mègavɔ̃ madzemadzee o, gake ele vevie be nànɔ ŋudzɔ.

Nukae nye Agranulocytosis ƒe dzesiwo?

Le go sia me la, dzesi vevitɔwo do ƒome kple dɔlékuiwo. Esiawo ate ŋu adze egɔme kpata, alo woate ŋu adzi ɖe edzi vivivi le ɣeyiɣi aɖe megbe. Kpɔe ɖa be dzesi siawo ɖi nusi nènya nyuie hã:

• Asrã xɔxɔ, vuvɔ kple ʋuʋu.
• Dzi ƒe tsotso kple gbɔgbɔ ƒe tsotso ƒe dzidziɖedzi.
• Agbemanɔamesi kple ɖeɖiteameŋu si gbɔ eme ƒe seselelãme.
• Kɔmeve (pharyngitis), aɖuɖɔtoe ƒe ʋuʋu, ʋu si dona le aɖuwo me.
• Abi le nu me kple ŋɔti me, si wɔnɛ be nuɖuɖu kple nunono mimi sesẽna.
• Ʋu ƒe sisi kpata (ʋusɔgbɔdɔ), taɖuame, alɔ̃madɔmadɔ, kple ɖewohĩ ame ƒe susu ƒe dɔwɔwɔ gɔ̃ hã.

Ne dzesi siawo tɔgbe le ŋuwò, vevietɔ ne edzɔna enuenu la, ele be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo godoo.

Nukatae agranulocytosis dzɔna? Nukawoe gbɔ wòtsona?

Nusi koŋ gbɔ esia tsoe nye ʋumenugbagbevi ɣi siwo woyɔna be neutrophils ƒe xexlẽme dzi ɖeɖe kpɔtɔ si me afɔku le le míaƒe ŋutilã me. Susu eve li siwo tae wòle alea ɖo:

• Alo míaƒe ŋutilã mewɔa neutrophil siwo sɔ gbɔ be woate ŋu awɔ dɔ nyuie o.
• Ne menye nenema o la, neutrophils siwo le ŋutilãa me la tsrɔ̃na, alo wokuna kaba.

Azɔ na míakpɔ nu siwo koŋ tae wòle alea ɖo.

Agranulocytosis si ƒe dome wonyi

Le esia me la, kuxi aɖe le domenyiŋusẽfianu aɖe si kpena ɖe ame ŋu be woawɔ neutrophils ŋu. Esia nye nɔnɔme si nɔa anyi le vidzidzi me (dzidzime). Le kpɔɖeŋu me, ne míezã Kostmann syndrome , alo congenital agranulocytosis , si nye dɔléle si mebɔ o la, zi geɖe la, dɔlékuiwo, dzoxɔxɔ, dɔdzẽ, kple ƒu ƒe kuxiwo nɔa vidzĩ siwo wodzi yeyee ŋu.

Agranulocytosis si woxɔ

Susu geɖewo ate ŋu anɔ esia ta. Na míakpɔ nusiwo wonye ɖa:

• Atike aɖewo: Esiae nye nusi gbɔ wòtsona wu . Dɔlékuiwutike aɖewo , tagbɔdɔlékuiwutikewo , kple ʋumenugbagbeviɣitikewo ate ŋu ahe nɔnɔme sia vɛ.
• Dɔlélenutsiŋutete ƒe dɔlélewo : Esiawo nye dɔléle siwo me dɔlélenutsiŋutete dzea ŋutilãa ŋutɔ ƒe lãmenugbagbeviwo dzi le. Kpɔɖeŋu aɖewoe nye lupus kple ƒunukpeƒetetedɔ .
• Ƒumeŋuɖui ƒe dɔlélewo kple ƒumeŋuɖui ƒe dɔmawɔmawɔ nyuie ƒe dɔlélewo: Le kpɔɖeŋu me , aplastic anemia . Ƒumeŋuɖui mee wowɔa míaƒe ʋumenugbagbeviwo le.
• Kansa: Kansa siwo gblẽa nu le ƒumeŋuɖui ŋu, vevietɔ ʋumenugbagbeviɣidɔ .
• Kansa dada (Chemotherapy): Atike siawo ate ŋu agblẽ lãmenugbagbevi siwo le lãmesẽ me kpakple lãmenugbagbevi siwo nye neutrophils hã dome.
• Aɖi alo atikewo zazã: Nusiwo le abe lead alo mercury ene zazã ɣeyiɣi didi.
• Dɔlékuiwo: Dɔlékui sesẽwo abe asrã , yɔmekpe , kple Rocky Mountain spotted fever .
• Nunyiame ƒe anyimanɔmanɔ: Nunyiame veviwo abe Vitamin B12 kple Folate ene ƒe anyimanɔmanɔ.

Amekae le afɔku me wu le nɔnɔme sia me?

Nyɔnuwo ate ŋu axɔ nɔnɔme sia vie wu ŋutsuwo. Azɔ hã, agranulocytosis ate ŋu adze amesiame si xɔ ƒe ɖesiaɖe dzi. Gake ame siwo gbɔna la koŋue le afɔku me:

• Ame siwo le kansa ƒe atikewo zãm.
• Ame siwo ŋu dɔlélenutsiŋutete ƒe dɔlélewo abe lupus kple ƒunukpeƒetetedɔ ene le .
• Ame siwo le atike aɖewo zãm, abe Clozapine (Clozaril®) , si nye tagbɔdɔlékuiwutike , Trimethoprim/sulfamethoxazole (BactrimTM) , kple Methimazole (Tapazole®), si nye ʋumenugbagbeviɣitike ene.

Nukawoe nye kuxi siwo ate ŋu ado mo ɖa le agranulocytosis ta?

Nɔnɔme sia ate ŋu ana ame naxɔ dɔlékuiwo enuenu alo anɔ anyi eteƒe nadidi (dɔlékui siwo nɔa anyi didi).

Ne agranulocytosis nɔa anyi wu kwasiɖa etɔ̃ va ɖo ene la, mɔnukpɔkpɔ li 100% be dɔlékui aɖe nadze ame dzi.

Ne womeda dɔ na dɔlékuiwutike o la, ate ŋu ahe dɔlélenutsiŋutete ƒe dɔwɔwɔ sesẽ si ate ŋu ade ame ƒe agbe afɔku me si woyɔna be dɔlékuiwutikewo vɛ. Sepsis nye dɔlékui sesẽ aɖe si kaka ɖe ŋutilã bliboa me. Amesiwo xɔ wu ƒe 65 alo amesiwo ŋu lãmesẽkuxi bubuwo le, abe dzidɔ, ayikudɔ, alo lãkusidɔ ene, ate ŋu axɔ kuxi siawo.

Aleke nèwɔna dea dzesi esia?

Aleke ɖɔkta wɔa anya agranulocytosis? Zi geɖe la, wowɔa ɖe afɔɖeɖe siawo dzi:

• Ʋu Xexlẽme Blibo (CBC) kple vovototodedeameme: Dodokpɔ sia léa ŋku ɖe lãmenugbagbevi vovovo siwo le wò ʋu me ŋu, vevietɔ neutrophils ƒe xexlẽme. Wobua neutrophil xexlẽme bliboa (ANC) si mede 100 le ʋu microlita ɖeka me o be enye agranulocytosis. (Asixɔxɔ si sɔ na amesi le lãmesẽ me wu 1,500.)
• Ƒumeŋuɖui me ɖeɖe kple aspirate: Ɣeaɖewoɣi la, woate ŋu awɔ dodokpɔ sia be woakpɔ alesi wò ƒumeŋuɖui le neutrophils wɔm.
• Dzesiawo kple atikewɔwɔ ŋutinya: Ðɔktaa abia nya wò tso wò dzesiwo, atike siwo nèno, dɔlékui siwo nèxɔ nyitsɔ laa, kple atike ɖesiaɖe si nèdo goe ŋu.
• Domenyiŋusẽfianu dodokpɔ: Ne wosusu be domenyiŋusẽfianu ƒe nɔnɔme aɖe le ame ŋu la, woate ŋu awɔ domenyiŋusẽfianu ƒe dodokpɔ atsɔ aɖo kpe edzi. Esia ate ŋu abia be woaɖe ŋutigbalẽ alo ʋudodokpɔ.

Nukawoe nye atike siwo wozãna na esia?

Nya nyuiae nye be atike aɖewo li na dɔléle sia, si nye agranulocytosis. Atikewɔwɔ nɔ te ɖe nusi gbɔ wòtso dzi.

• Atike Siwo Hea Wòa Dzudzɔ: Ne atike aɖee le wò dzesiwo hem vɛ la, nu gbãtɔ si nàwɔe nye be nàdzudzɔ enono dedie abe alesi wò ɖɔkta gblɔe ene. Mègadzudzɔ atikewo nono gbeɖe ne mèbia ɖɔkta o.
• Dɔlékuiwutikewo: Ne dɔlékui aɖe le ŋuwò la, wò ɖɔkta aŋlɔ dɔlékuiwutike siwo sɔ kple atike bubuwo na wò be wòaɖe dzesiawo dzi akpɔtɔ.
• Granulocyte colony-stimulating factor (G-CSF): Woate ŋu ado atike sia ƒomevi be wòakpe ɖe ŋutilãa ŋu wòawɔ neutrophils kabakaba wu. Kpɔɖeŋu aɖewoe nye atikewo abe Filgrastim (Neupogen®) , Pegfilgrastim (Neulasta®) , kple Lenograstim (Granocyte®) .
• Dɔlélenutsiŋutete ƒe dɔlékuiwutikewo: Ne dɔlélenutsiŋutete ƒe dɔléle aɖe gbɔe dɔlélea tso la, woate ŋu aŋlɔ atike siwo tea dɔlélenutsiŋutete ɖe to, abe Prednisone ene.
• Ƒumeŋuɖui dodo: Ne dɔdamɔnu bubuwo medze edzi o la, ahiã be woado ƒumeŋuɖui na wò. Le esia me la, woana ƒumeŋuɖui wò tso nunala si le lãmesẽ me gbɔ. Esia akpe ɖe wò ŋutilã ŋu wòagawɔ neutrophils siwo le lãmesẽ me ake.
• Mɔxexe ɖe dɔlékuiwo xɔxɔ nu: Esia le vevie ŋutɔ. Ele be amesiwo ŋu dɔléle sia le naɖɔ ŋu ɖo vevie be woaƒo asa na dɔlékuiwo xɔxɔ.
• Klɔ asi nyuie kple adzalẽ ɣesiaɣi.
• Ƒo asa na teƒe siwo amewo sɔ gbɔ ɖo alesi nàte ŋui.
• Do motsyɔnu/ametakpɔnu ne èle dodom.
• Ðo dze kple wò ɖɔkta tso nu bubu siwo nàte ŋu awɔ be màgadze dɔ o ŋu.

Aleke gbegbee nye lãme ahaya kaba le atikewɔwɔ vɔ megbe?

Ɣeyiɣi si nàhaya la nɔ te ɖe nusi gbɔ wò neutrophil ƒe xexlẽme si le ʋɛ wu kple alesi nɔnɔmea nu sẽe dzi. Ne enye atike aɖe ƒe nugbegblẽ le ame ŋu la, zi geɖe la, ate ŋu axɔ kwasiɖa ɖeka va ɖo kwasiɖa etɔ̃ hafi wò ʋumenugbagbevi dzĩwo ƒe xexlẽme natrɔ ava nɔ abe alesi wòle ene ne èdzudzɔ atikeawo nono vɔ.

Ðe woate ŋu axe mɔ ɖe esia nua?

Ɣeaɖewoɣi la, womate ŋu axe mɔ ɖe agranulocytosis nu keŋkeŋ o. Gake ne èle atike si ate ŋu aɖe wò ʋumenugbagbeviɣiwo dzi akpɔtɔ (e.g., atikewɔmɔnu, tagbɔdɔlélawo ƒe atike aɖewo) zãm la, ele vevie be nàƒo nu kple wò ɖɔkta eye nàna woalé ŋku ɖe wò ʋumenugbagbevi dzĩwo ƒe agbɔsɔsɔ ŋu edziedzi. Ne èle kansa ƒe atikewo zãm la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàdo G-CSF be wòakpe ɖe ŋuwò nàdzi neutrophil ƒe wɔwɔ ɖe edzi.

Nukae nye mɔkpɔkpɔ na amesi ŋu agranulocytosis le?

Togbɔ be esia nye dɔléle si woate ŋu ada hã la, emetsonuwo ate ŋu ato vovo tso ame ɖeka gbɔ yi bubu gbɔ. Ne wodae nyuie, alo ne wodzudzɔ atike si ɖea ʋumenugbagbeviɣidɔ dzi kpɔtɔna la, zi geɖe la, nɔnɔmea nu yina.

Gake ne womewɔ atike nɛ o la, dɔlékui sesẽwo kple ku gɔ̃ hã ate ŋu adzɔ. Zi alesi neutrophil ƒe xexlẽme nɔa afɔku ƒe agbɔsɔsɔ me ɣeyiɣi didi la, zi nenemae dɔlékuiwo xɔxɔ kple kuxiwo ƒe afɔkua dzina ɖe edzii. Esia nye nyateƒe vevietɔ na amesiwo xɔ wu ƒe 65 kple amesiwo ŋu atikewɔwɔ me dɔléle siwo gbɔ wòtso (abe ayiku, dzi, alo lãkusidɔ ene).

Ɣekaɣie wòle be nàkpɔ ɖɔkta?

Agranulocytosis nye dɔléle si ate ŋu ade ame ƒe agbe afɔku me. Eyata ele vevie be woakpɔ dɔlélea ahadae enumake. Yi ɖɔkta enumake ne dzesi siawo dometɔ aɖe le ŋuwò:

• Ne èxɔa dɔlékuiwo enuenu.
• Ne dɔlékuia xɔa ɣeyiɣi didi hafi wòhaya.
• Ne dɔlékuiwo ƒe dzesiwo abe dzoxɔxɔ, vuvɔ, alo ŋɔti me veve ene dze le ŋuwò.

Ne dɔléle aɖe si tso dɔlélenutsiŋutete gbɔ le ŋuwò alo nèle atike siwo ɖea wò ʋumenugbagbeviɣiwo dzi kpɔtɔna zãm la, mègadzo le wò atikewɔwɔ me dodokpɔwo dzi o. Dodokpɔ na wò ɖɔkta edziedzi ate ŋu akpe ɖe ŋuwò nàlé ŋku ɖe wò neutrophil ƒe agbɔsɔsɔ ŋu eye wòakpe ɖe ŋuwò nàxe mɔ ɖe dɔlékuiwo xɔxɔ nu.

Nu vevitɔ kekeake siwo dzi wòle be míaɖo ŋkui (Take-Home Message) .

Enyo, eyata mina míagbugbɔ aƒo nu tso nya vevi aɖewo ŋu tso nusiwo ŋu míeƒo nu tsoe me:

• Agranulocytosis nye dɔléle sesẽ aɖe gake woate ŋu adae si me ʋumenugbagbevi ɣi siwo woyɔna be neutrophils dzi ɖena kpɔtɔna ŋutɔ.
• Ne dzesiwo abe dɔlékuiwo xɔxɔ enuenu, dzoxɔxɔ, alo ŋɔti me veve ene le ŋuwò la, yi ɖɔkta gbɔ enumake.
• Esia ate ŋu atso atike aɖewo, dɔléle siwo dɔlélenutsiŋutete hena vɛ, kple kansa dada gbɔ.
• Atikewɔwɔ ate ŋu anye atike si doa dziku na ame la dzudzɔ, dɔlékuiwutikewo, G-CSF dodo, kple ɖewohĩ ƒumeŋuɖui dodo na ame.
• Ðokuiwò ta kpɔkpɔ tso dɔlékuiwo me le vevie ŋutɔ. Àte ŋu akpɔ ɖokuiwò ta ne èwɔ nu tsɛwo abe asikɔklɔ enuenu kple ametakpɔnu dodo ne èle dutoƒo ene.
• Ne èle afɔku me na esia (e.g., ne èno atike aɖewo) la, mègadzo le ɖɔkta gbɔ yiyi o.

Mele mɔ kpɔm be nyatakaka sia aɖe vi na wò. Nɔ lãmesẽ me!