Ðe tsi dona le wò ŋutilã me alea? Mina míaƒo nu tso Capillary Leak Syndrome ŋu!

Èse Capillary Leak Syndrome ŋu nya kpɔa? Ŋkɔa ate ŋu aɖi nya sesẽ vie. Gake ne míagblɔe bɔbɔe la, enye nɔnɔme si me ʋua ƒe akpa si nye tsi si woyɔna be plasma la dona le ʋuka suesuesue siwo le míaƒe ŋutilã me, siwo woyɔna be ʋuka siwo me ʋu sina tona me. Lãmetsi sia sina yia míaƒe lãmekawo, lãkusiwo, ŋutinuwo, kple ŋutilã ƒe dowo me. Esia ate ŋu anye nɔnɔme sesẽ aɖe, eyata ele vevie be nànyae.

Nukae nye nusi woyɔna be ʋuka siwo me ʋu sina tona ƒe dɔléle sia?

Enyo, mina míaɖe eme vie. Tsɔe be tsi ƒe pɔmpiwo ƒe ɖoɖo aɖe le wò ŋutilã me. Pɔmpi siawoe nye míaƒe ʋukawo. Woyɔa pɔmpi suesuesue siwo le sue ŋutɔ siwo le esia me be ʋuka siwo me ʋu sina tona. Esiawoe nye mɔ̃ siwo me oxygen kple nunyiamewo tona yia míaƒe ŋutilã ƒe akpawo katã. Eyata le `(Capillary Leak Syndrome)` me la, ʋua ƒe akpa si nye tsi, si nye plasma , dona to ʋuka sue siawo me. Ele abe tsi si le dodom tso tsido me ene.

Lãmetsi sia si le dodom la nana tsi ƒoa ƒu ɖe ŋutilãa ƒe akpa vovovowo. Le kpɔɖeŋu me, tsi sia ate ŋu age ɖe lãmekawo, lãkusiwo, ŋutinu vovovowo, alo teƒe (ŋutilã ƒe dowo) siwo me ŋutinuwo le.

`(Capillary Leak Syndrome)` sia ƒe nudzɔdzɔwo ateŋu adzɔ zi geɖe le ƒea me, alo zi ɖeka pɛ ko le agbe me. Gake ne womedae kaba o la, wò ʋu ƒe sisi ate ŋu aɖiɖi kpata, si ana wò ŋutinuwo nawɔ dɔ nyuie o eye ɣeaɖewoɣi la, àku gɔ̃ hã. Eyata esia menye nusi woabu nu tsɛe o.

Atike aɖeke meli na esia si anɔ anyi ɖaa haɖe o. Gake ele vevie be woayi atikewɔƒe kaba be woaɖu dzesiawo dzi. Ɣeaɖewoɣi la, anya wɔ be woaxe mɔ ɖe amedzidzedze siwo ava dzɔ le etsɔme nu to atikewo zazã dzi yiyi alo saline dodo me.

Ðe esia ƒomevi aɖewo lia? Aleke woto vovoe?

Ẽ, `(Capillary Leak Syndrome)` ƒomevi vevi eve li. Na míakpɔ nusiwo wonye ɖa.

• Systemic Capillary Leak Syndrome: Wogayɔnae be ``Primary Capillary Leak Syndrome'' alo ``Clarkson ƒe dɔléle'', esia nye nɔnɔme si me amedzidzedzewo dzɔna enuenu , le ame si le lãmesẽ me le dzɔdzɔme nu gɔ̃ hã me.
• Secondary Capillary Leak Syndrome: Esia nye ne amedzidzedzea dzɔ zi ɖeka le dɔléle, nɔnɔme, alo atike bubu aɖe ta.

Kpuie ko la, ɖeka nye nusi ate ŋu adzɔ atraɖii, eye evelia nye nusi dzɔna hena ɣeyiɣi aɖe le susu bubu aɖe ta.

Amekawoe ate ŋu axɔ nɔnɔme sia wu?

``Systemic Capillary Leak Syndrome'' nye dɔléle si mebɔ kura o.Woka nya ta be ame siwo mede 500 o ye ŋu dɔléle sia le le xexeame katã. Ebɔ ɖe ƒe titinatɔwo dome wu. Ƒã ŋutɔ le ɖevi suewo me. Gake esi wònye be wobua dɔléle sia vodadatɔe ɣeaɖewoɣi be dɔléle bubu aɖe le wo ŋu ta la, amesiwo ŋu dɔléle sia le ƒe xexlẽme ŋutɔŋutɔ ate ŋu asɔ gbɔ wu sã.

Gake Secondary Capillary Leak Syndrome ate ŋu adzɔ le ƒe ɖesiaɖe me. Dɔlékui aɖewo, atikewɔwɔ ƒe nɔnɔmewo, kple atikewo ate ŋu ahee vɛ.

Nukae dzɔna ɖe ŋutilãa dzi ne esia dzɔ? (Afɔɖeɖe etɔ̃) .

Woateŋu ama nusi dzɔna le míaƒe ŋutilã me le `(Capillary Leak Syndrome)` ƒe amedzidzedze sia me ɖe akpa etɔ̃ me. Na míakpɔ nusiwo wonye ɖa.

Akpa gbãtɔ: Hafi dzesiawo nadze (Prodromal phase) .

Esiae nye ɣeyiɣi si do ŋgɔ na amedzidzedze ŋkeke ɖeka alo eve. Le ɣeyiɣi sia me la, àte ŋu adze dzesi aɖewo kpɔkpɔ gɔme.

• Sese le eɖokui me be ɖeɖi te ye ŋu
• Tsikɔwuame si dzi ɖe edzi
• Nuwo abe lolo ƒe dzidziɖedzi kpata ene ate ŋu adzɔ.

Akpa evelia: Tsi si dona alo gbɔgbɔyɔyɔ ƒe akpa

Esiae nye ɣeyiɣi si me amedzidzedzea dzɔna ŋutɔŋutɔ. Nusi dzɔnae nye be tsi kple albumin (protein ƒomevi aɖe si le ʋua me) sina tso wò ʋukawo me yia teƒe siwo le wò lãkusiwo dome. Esia ɖea ʋu si tsɔa ɔksidzin ƒe agbɔsɔsɔ dzi kpɔtɔna. Wò ʋu ƒe sisi dzi ɖena kpɔtɔna, eye ʋumenugbagbevi dzĩwo ƒoa ƒu ɖekae, si wɔnɛ be wò ʋu nɔa ƒoƒom ɖe edzi. Lãmetsi sia si le dodom la nana ʋu ƒe agbɔsɔsɔ dzi ɖena kpɔtɔna, si woyɔna be hypovolemia .

Akpa etɔ̃lia: Le amedzidzedzea megbe `(Post-leak phase alo recruitment phase)`

Esia nye ɣeyiɣi si kplɔ amedzidzedzea ƒe nuwuwu ɖo. Nusi dzɔnae nye be wò ʋukawo gadzea tsi kple albumin xɔxɔ tso lãkusiawo me ake. Gake le ɣeyiɣi sia me la, wò ŋutilã ate ŋu aƒo tsi geɖe nu ƒu (tsi si sɔ gbɔ akpa) . Esia wɔnɛ be wò ŋutilã ate ŋu awɔ aɖuɖɔ fũ akpa (polyuria) eye tsi ate ŋu ayɔ wò lãkusiwo me fũ (pulmonary edema).

Bu eŋu kpɔ, ele abe ƒumebɔbɔ si le tsi xɔm ene. Gbã la, tsi la dona le ŋutilãa me, eye emegbe ne egaxɔe kabakaba akpa la, exɔa nu geɖe wu alesi wòle be wòaxɔe.

Nukae hea esia vɛ?

Azɔ mina míalé ŋku ɖe nusi ateŋu ahe `(Capillary Leak Syndrome)` sia vɛ ŋu.

Nusiwo hea `(Systemic Capillary Leak Syndrome)` vɛ

Ne míagblɔe tututu la, womenya nusi tututu gbɔ Systemic Capillary Leak Syndrome tsona haɖe o. Numekulawo xɔe se be ate ŋu atso alesi míaƒe dɔlélenutsiŋutete wɔa nu ɖe ​​dɔléle alo dɔlékui aɖe ŋu gbɔ.

Nusiwo hea `(Secondary Capillary Leak Syndrome)` vɛ

Susu geɖewo tae wòle alea ɖo. Nusi gbɔ wòtsona wue nye nɔnɔme aɖe si woyɔna be sepsis . Eyae nye kuxi si ate ŋu ade ame ƒe agbe afɔku me si dɔlékui aɖe hena vɛ. Tsɔ kpe ɖe eŋu la, nu bubuwo hã li siwo gbɔ wòtsona:

• Dɔléle siwo dɔlélenutsiŋutete hena vɛ:Nusi dzɔna le esia mee nye be mía ŋutɔwo ƒe dɔlélenutsiŋutete dzea mía ŋutɔwo ƒe lãmenugbagbevi siwo le lãmesẽ me dzi.
• Vovototodedeameme ƒe dɔléle: Kuxi si ate ŋu ado mo ɖa le ʋumenugbagbeviɣidɔ ƒomevi aɖewo (acute promyelocytic leukemia alo acute myeloid leukemia) dada me.
• Engraftment syndrome: Kuxi si ate ŋu ado mo ɖa le ƒumeŋuɖui dodo vɔ megbe.
• Hemophagocytic lymphohistiocytosis: Nɔnɔme si ate ŋu ade ame ƒe agbe afɔku me si dɔlélenutsiŋutete ƒe dɔwɔwɔ fũ akpa hena vɛ.
• Ovarian hyperstimulation syndrome: Kuxi aɖe si ate ŋu ado mo ɖa le vidzidzi ƒe atikewɔwɔwo me.
• Ricin ƒe aɖi.
• Da ƒe ɖuɖu.
• Viral hemorrhagic fevers: Dɔlékui siwo xɔa ame ƒe ƒuƒoƒo si dɔlékuiwo hena vɛ.

Atike aɖewo, abe atike siwo tsia kansa nu gemcitabine (gemcitabine - Gemzar®) kple tagraxofusp (tagraxofusp - Elzonris®) , hã ate ŋu ahe esia vɛ (Secondary Capillary Leak Syndrome).

Dzesi kawoe dzena do ŋgɔ na dɔléle sia ƒe gɔmedzedze?

Zi geɖe la, ŋkeke ɖeka alo eve do ŋgɔ na ``Capillary Leak Syndrome'' ƒe amedzidzedze, si fia be le ``prodromal phase'' me la, àte ŋu akpɔ dzesiwo abe:

• Ƒodo ƒe vevesese alo lãmekawo ƒe vevesese (myalgia).
• Ðeɖiteameŋu alo gbɔdzɔgbɔdzɔ si gbɔ eme.
• Taɖuame .
• Tsikɔwuame si dzi ɖe edzi.
• Dzikudodo, dzikudodo kabakaba.
• Xeɖeɖe.
• Kpekpeme ƒe dzidziɖedzi kpata.
• Dɔlékui ƒe dɔléle alo gbɔgbɔtsixe ƒe akpa si le etame ƒe dɔléle ƒe dzesiwo.

Ne èkpɔ dzesi siawo tɔgbe la, mègabu eŋu nu tsɛe o, agblɔ be, "Oo, ɖewohĩ vuvɔ koe wònye," vevietɔ ne èto nuteƒekpɔkpɔ mawo tɔgbe me kpɔ.

Dzesi kawoe dzena ne dɔléle aɖe le ŋuwò?

Le `(Capillary Leak Syndrome)` ƒe amedzidzedze me, si fia be le `(leak alo resuscitation phase)` me la, dzesiwo ateŋu ato vovo tso ame ɖeka gbɔ yi bubu gbɔ. Gake esiawoe nye dzesi siwo bɔ siwo woate ŋu akpɔ:

• Ŋutilã ƒe vuvu, vevietɔ abɔ kple afɔwo (peripheral edema).
• Dɔmetɔtrɔ.
• Ʋu ƒe sisi ƒe ɖiɖi (ʋusɔgbɔdɔ).
• Ʋu ƒe sisi (hypercoagulability) - Esia ateŋu atso ʋumenugbagbevi dzĩwo ƒe dzidziɖedzi (hematocrit) alo ʋumenugbagbevi ɣiwo ƒe dzidziɖedzi (leukocytosis) gbɔ.

Aleke ɖɔktawo wɔna dea dzesi esia?

Ðɔkta aɖe akpɔ Capillary Leak Syndrome to wò atikewɔwɔ ŋutinya biabia kple ŋutilãmedɔdada me. Woalé ŋku ɖe eŋu be wò ʋu ƒe sisi le sue hã.

Azɔ hã, hafi woaɖo kpe edzi be esia nye Capillary Leak Syndrome la, ele be woaɖe nɔnɔme bubuwo ɖa. Woate ŋu awɔ ʋudodokpɔ geɖe atsɔ awɔ esia:

• Kpɔe ɖa be hematocrit (ʋumenugbagbevi dzĩ siwo le ʋua me ƒe xexlẽme) sɔ gbɔ hã.
• Kpɔe ɖa be hemoglobin (protein si le ʋumenugbagbevi dzĩwo me) sɔ gbɔ hã.
• Kpɔe ɖa be protein mesɔ gbɔ ɖe ʋua me hã o (hypoalbuminemia).

Gakpe ɖe eŋu la, woateŋu awɔ ʋudodokpɔ atsɔ akpɔe ɖa be dɔlélenutsiŋutete ƒe protein si mesɔ o si woyɔna be ``monoclonal gammopathy, alo M protein'' le ʋua me hã. Ame siwo ŋu ``Capillary Leak Syndrome'' le ate ŋu akpɔ ``M protein'' sia si mesɔ o le woƒe ʋu me.

Aleke wowɔa atike nɛ? Ðe woate ŋu adaea?

Nublanuitɔe la, atike aɖeke meli si woatsɔ ada Capillary Leak Syndrome si anɔ anyi ɖaa o. Ðɔktawo dzea agbagba be yewoaɖu dzesiawo dzi ahaxe mɔ ɖe kuxiwo nu.

Le ``Capillary Leak Syndrome'' ƒe amedzidzedze me la, ɖɔktawo dzea agbagba be yewoaɖu ʋu ƒe sisi dzi eye yewoalé ʋu ƒe sisi nyuie ɖe ŋutinuwo me ɖe asi. Wodzea agbagba hã be yewoaxe mɔ ɖe abi si gbɔ eme kple tsi ƒe ƒoƒo ƒu nu. Woate ŋu azã:

• Glucocorticoids: Esiawo nye steroid ƒomevi aɖe si kpena ɖe ame ŋu be tsi si dona le ʋukawo me dzi ɖena kpɔtɔna.
• Tsi siwo wodona ɖe ʋuka me: Wonaa nuwo abe saline ene be wòana ʋu nayi ŋutinuwo abe ayiku ene me geɖe wu.

Zi geɖe la, ahiã be woaxɔ wò ɖe kɔdzi le amedzidzedze aɖe megbe. Le atikewɔwɔ me la, wò ɖɔkta ayi edzi anɔ ŋku lém ɖe wò ʋu ƒe sisi kple ʋu ƒe sisi ŋu be yeakpɔ egbɔ be tsi mesɔ gbɔ ɖe wò ŋutilã me o, si ate ŋu ahe kuxi bubuwo abe aklã me ʋuʋu kple dzi ƒe tsotso kpata ene vɛ.

Ne Capillary Leak Syndrome, si woyɔna be post-leak phase alo recruitment phase, ƒe amedzidzedze vɔ megbe la, ɖɔkta ate ŋu aŋlɔ tsinyegoetsitike (atike si nana nèwɔa aɖuɖɔ geɖe) be wòaɖe tsi si sɔ gbɔ ɖe wò ŋutilã me dzi akpɔtɔ.

Ðe woate ŋu axe mɔ na Systemic Capillary Leak Syndrome (SCLS) be wòagadzɔ akea?

Màte ŋu axe mɔ na Systemic Capillary Leak Syndrome ƒe dzɔdzɔ le gɔmedzedzea me o. Gake, ne ènya dze dziwò ko la, ènya be nɔnɔmea le ye ŋu.

Gake atikewo nono edziedzi alo dzetsi dodo ate ŋu akpe ɖe ame ŋu be woaxe mɔ ɖe amedzidzedze siwo ava dzɔ le etsɔme nu eye wòaɖe woƒe sesẽ dzi akpɔtɔ. Atikewɔwɔ siawo ate ŋu anye:

• Dɔlélenutsiŋutete ƒe globulin (IVIG) si wodona ɖe ʋuka me ɣleti sia ɣleti .
• Atike siwo woano na asrã, abe theophylline (theophylline - Elixophyllin®), terbutaline (terbutaline - Brethine®), kple montelukast (montelukast - Singulair®) ene .
• Ðe dɔdzẽ dzi kpɔtɔSteroid-tikewo.

Nukae nye etsɔme na amesiwo le nɔnɔme sia lém? `(Nukpɔsusu)`

Zi geɖe la, woate ŋu atsɔ mɔxexeɖedɔléle nu ƒe atikewɔwɔ akpɔ Systemic Capillary Leak Syndrome gbɔ. Anɔ eme be atikewɔwɔa akpɔ dzidzedze ne wokpɔ dɔlélea kaba eye kuxi siwo dona tso eme la mesɔ gbɔ o. Kuxi sesẽ siwo ate ŋu ado mo ɖa le Capillary Leak Syndrome ŋu dometɔ aɖewoe nye:

• Compartment syndrome: Nyaƒoɖeamenu si dzina ɖe edzi le lãmekaa me eye ʋu ƒe sisi dzi ɖena kpɔtɔna.
• Lãmetsiwo ƒe ƒuƒoƒo ɖe dzi kple lãkusi ŋu (dzitodzito ƒe ʋuʋu, dzitodzito me tsi si dona le dzitodzito me, kple dzitodzito me tsi si dona le ʋuka me).
• Dzi ƒe dɔmawɔmawɔ nyuie.
• Ayiku ƒe dɔmawɔmawɔ nyuie.
• Ahɔhɔ̃mekawo ƒe Dɔléle.
• Aklã me ʋuʋu.
• Rhabdomyolysis: Ayiku ƒe dɔmawɔmawɔ nyuie le lãmekawo ƒe gbegblẽ ta.
• Gbagbãdᴐ.

Esiawo aɖi vɔvɔ̃, gake abe alesi míegblɔe va yi ene la, atikewɔwɔ kaba kple wo gbɔ kpɔkpɔ nyuie le vevie ŋutɔ.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ne èsusu be Capillary Leak Syndrome ƒe amedzidzedze le ye ŋu la, yi ɖɔkta gbɔ enumake. Woate ŋu akpe ɖe ŋuwò nàɖu wò dzesiwo dzi eye woana gbɔdzɔe wò.

Ðo ŋku edzi be togbɔ be esia nye nɔnɔme si mebɔ o hã la, ele vevie be nànya dzesiawo eye nàdi atikewɔlawo ƒe aɖaŋuɖoɖo kaba ne ɖikeke le ŋuwò.

Gbedasi si Wotsɔ Yi Aƒeme

Enyo, eyata mina míagbugbɔ aƒo nu tso nya vevitɔ kekeake siwo ŋu míeƒo nu tsoe ŋu:

• Esiae nye esime ʋua ƒe akpa si nye tsi (plasma) do go le ʋuka suesuesue siwo le míaƒe ŋutilã me (capillaries) me.
• Esia ate ŋu adzɔ zi ɖeka alo enuenu.
• Ne womedae o la, kuxi sesẽwo ate ŋu ado mo ɖa, eyata ele vevie be woakpɔ atikewɔƒe kaba.
• Togbɔ be atike aɖeke meli si anɔ anyi ɖaa o hã la, atikewɔmɔnu aɖewo li siwo dzi woato aɖu dzesiawo dzi ahaxe mɔ ɖe amedzidzedze le etsɔme nu.
• Ne èsusu be dzesi siawo dometɔ aɖe le ŋuwò la, yi ɖɔkta gbɔ enumake. Zi alesi nèkpɔ dɔlélea kaba eye nèdze edada gɔme la, zi nenemae mɔnukpɔkpɔ asu asiwò be nàhayae.

Eyata, mele mɔ kpɔm be nyatakaka sia aɖe vi na wò. Nɔ lãmesẽ me!

` Capillary Leak Syndrome, Plasma Leak, Ʋu ƒe Ʋuʋudedi, Clarkson ƒe Dɔléle, Edema, Tsi ƒe sisi le Ŋutilã me