Ðe ʋumenugbagbevi dzĩ siwo le wò ʋu me ƒe nɔnɔme le tɔtrɔma? Mina míaƒo nu tso (Poikilocytosis) ŋu!

Ðe ɖeɖi tea ŋuwò eye kuviawɔwɔ le ŋuwò ɣeaɖewoɣi le susu aɖeke manɔmeea? Alo ɖe ɖɔkta aɖe lé ŋku ɖe wò ʋudodokpɔ ŋuti nyatakaka ŋu kpɔ hegblɔ nya aɖe abe, "Tɔtrɔ vi aɖe va le wò ʋumenugbagbevi dzĩwo ƒe nɔnɔme mea?" Le ɣeyiɣi mawo tɔgbe me la, nya siwo míesena dometɔ ɖekae nye `(Poikilocytosis)` (woyɔnae be: poi-ki-lo-say-to-sis). Mègavɔ̃ akpa ne èse ŋkɔ sia o. Esia menye dɔléle o, gake ate ŋu anye dzesi be nu bubu aɖe le edzi yim le míaƒe ŋutilã me. Eyata, ele vevie ŋutɔ be nànya esia.

Nuka tututue nye `(Poikilocytosis)`?

Kpuie ko la, ``Poikilocytosis`` fia be ʋumenugbagbevi dzĩ siwo le míaƒe ʋu me ƒe xexlẽme ɖedzesi aɖe (si fia be wu 10%) ƒe nɔnɔme mebɔ o. Fifia ɖewohĩ èle eŋu bum be, "Ekema nukatae ʋumenugbagbevi dzĩwo ƒe nɔnɔme le vevie?"

Bu eŋu kpɔ ko, lãmenugbagbevi, lãmenugbagbevi, kple ŋutinu bubu ɖesiaɖe si le míaƒe ŋutilã me hiã ŋusẽ hafi ate ŋu anɔ agbe ahawɔ dɔ. Oxygen ye naa ŋusẽ ma. Amekae nya, wotsɔa ɔksidzin sia, abe gas-go aɖe tsɔtsɔ va aƒeme ene, yia ŋutilã bliboa me? Emae nye míaƒe ʋumenugbagbevi dzĩwo. Zi geɖe la, ne èno ʋumenugbagbevi dzĩ si le lãmesẽ me la, wo katã ƒe lolome kple nɔnɔme sɔ. Abe gaku goglo (abe disk ene) si le ƒoƒom vie le axa eveawo.

Eyata ne ʋumenugbagbevi dzĩ siawo ƒe nɔnɔme trɔ (`(Poikilocytosis)`) alo woƒe lolome trɔ (bubu bubu aɖe li si woyɔna be `(Anisocytosis)`) la, womate ŋu atsɔ oxygen nyuie o. Ɣemaɣie míexɔa nɔnɔmewo abe ʋusɔgbɔdɔ (ʋu ƒe anyimanɔmanɔ le ʋua me) ene. Ema fia be ŋutilãa ƒe lãmenugbagbeviwo mekpɔa ɔksidzin si sɔ o, si fia ŋusẽ.

Nukawoe nye ʋumenugbagbevi dzĩwo ƒe nɔnɔme si mesɔ o? (Poikilocytes) .

Ðɔktawo bua ʋumenugbagbevi dzĩ siawo siwo ƒe nɔnɔme mesɔ o (siwo woyɔna hã be `Poikilocytes`) ɖe hatsotsowo me le woƒe dzedzeme nu. Ne `(Poikilocytosis)` le ʋu me la, àte ŋu akpɔ esiawo dometɔ ɖeka alo esi wu nenema:

• Acanthocytes / Spur cells : Esiawo le abe ŋù ƒe alɔ ene. Woƒe nu didi siwo keke, siwo le abe aŋgba ene siwo dona tso lãmenugbagbeviwo ƒe lãkusi me.
• Codocytes / Target cells : Esiawo le abe target board ene. Kplɔ̃ doviviti aɖe le titina.
• Dacrocytes / Aɖatsi lãmenugbagbeviwo : Aɖatsi ƒe nɔnɔme. Lãmenugbagbevi la ƒe akpa ɖeka le sue eye wòle ɖaa.
• Drepanocytes / Sickle cells : Esiawo nye lãmenugbagbevi tsɛ siwo le abe sickle ene siwo woate ŋu akpɔ le amesiwo ŋu sickle cell dɔléle le me.
• Echinocytes : Abe ƒumelã si woyɔna be sea urchin ene la, lãmenugbagbevi la ƒe akɔta le didiƒe sɔsɔe le eƒe akpa bliboa katã.
• Elliptocytes / Ovalocytes alo Cigar cells : Esiawo ƒe nɔnɔme le abe oval ene eye wodidi le mɔ si mebɔ o nu. Woƒe lolome ate ŋu atso azi ƒe nɔnɔme dzi va ɖo sigaret ƒe nɔnɔme dzi.
• Schistocytes : Esiawo nye ʋumenugbagbevi dzĩwo ƒe kakɛwo. Zi geɖe la, woƒe dzedzeme nɔa ƒuƒlu eye wogbãna, gake woate ŋu anye nɔnɔme ɖesiaɖe.
• Spherocytes: Wole dzogoe ene me. Abe bɔl sue aɖe ene.

Woate ŋu atsɔ ƒomevi siawo dometɔ ɖesiaɖe asɔ kple atikewɔwɔ me nɔnɔme aɖewo koŋ.

Nukae nye nɔnɔme sia ƒe dzesiwo?

``Poikilocytosis`` ƒe dzesiwo toa vovo le nusi gbɔ wòtso nu. Gake dzesi siwo wokpɔna zi geɖe la sɔ kple esiwo ʋusɔgbɔdɔ hena vɛ.

Ʋusɔgbɔdɔ ƒe dzesi aɖewoe nye esi:

• Gbɔdzɔgbɔdzɔ alo ɖeɖiteameŋu si gbɔ eme (ɖeɖiteameŋu ƒe seselelãme ko).
• Yagbɔgbɔ sesẽ (dyspnea) – gbɔgbɔtsixetsixe ne wowɔ dɔ suewo gɔ̃ hã.
• Dzi ƒe tsotso kabakaba alo esi mesɔ o (arrhythmia).
• Ɣeaɖewoɣi la, èsea "whooshing" gbeɖiɖi aɖe le wò towo me (`(pulsatile tinnitus)`).
• Taɖuame .
• Taɖuame .
• Ŋutilã si ƒe ŋutigbalẽ le ɣie .
• Akɔtave .

Ne dzesi siawo dometɔ ɖeka alo esi wu nenema le ŋuwò la, anyo wu be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo.

Nukatae esia le dzɔdzɔm? Nukawoe nye susu siwo tae?

Woate ŋu ama nusiwo gbɔ ʋumenugbagbevi dzĩ siawo ƒe nɔnɔme si mesɔ o tsona la ɖe hatsotso vevi eve me: esiwo ƒe dome wonyi kple esiwo woxɔ . Nɔnɔme aɖewo, abe Myelodysplastic Syndrome ene, ate ŋu ahe evea siaa vɛ.

Nɔnɔme Siwo Dome Ame

Zi geɖe la, vodada aɖe si le domenyiŋusẽfianu ŋuti nyatakaka (DNA) si ʋumenugbagbevi dzĩ hiã be wòatsi, awɔ dɔ, ahanɔ agbe nyuie gbɔe nusiwo gbɔ wòtsona. Ʋumenugbagbevi dzĩ siwo ƒe wɔwɔme mesɔ o alea la gblẽna kabakaba hafi ŋutilãa te ŋu wɔa lãmenugbagbevi yeyewo. Woyɔa esia be ʋusɔgbɔdɔ si me ʋu sina tona .

Nɔnɔme aɖewo siwo wodzina siwo hea `(Poikilocytosis)` vɛ:

• `(Domenyinyi ƒe Elliptocytosis)`
• `(Domenyinyi ƒe Spherocytosis)`
• `(McLeod ƒe Dɔléle)`
• `(Pyruvate Kinase ƒe Gbɔdzɔgbɔdzɔ)`
• `(Sickle Cell Dɔléle)` (Sickle Cell Dɔléle) .
• `(Thalassemia)`

Zi geɖe la, nusiawo nyea nusiwo wotsɔna tsoa dzidzimewo me.

Nɔnɔme Siwo Woxɔ

Le ɣeyiɣi aɖe megbe la, atikewɔwɔ ƒe nɔnɔme aɖewo hã ate ŋu ana ʋumenugbagbevi dzĩwo ƒe nɔnɔme natrɔ. Le kpɔɖeŋu me, ne nunyiame siwo ŋutilã hiã be wòawɔ ʋumenugbagbevi dzĩ siwo le lãmesẽ me, abe vitamin B12, folate, kple iron ene, mesu esi o la, ʋusɔgbɔdɔ vovovowo ate ŋu adzɔ. Poikilocytosis nye nunyiame ƒe veve siawo ƒe dzesi si bɔ. Ate ŋu atso dɔléle siwo doa kplamatse ʋumenugbagbevi dzĩwo wɔwɔ, abe kansa aɖewo ene hã gbɔ.

Nɔnɔme siwo va emegbe siwo hea `(Poikilocytosis)` vɛ dometɔ aɖewoe nye:

• Ʋusɔgbɔdɔ si Trɔna le Dɔlélenutsiŋutete Ŋu
• Dzobibi (ne ekeke ta) .
• `(Celiac Dɔléle)`
• Dɔlékui vovovowo
• Ʋusɔgbɔdɔ si me iron mesɔ gbɔ ɖo o
• Ayikudɔléle
• Ʋumenugbagbeviɣidɔ (ʋumenugbagbeviɣidɔ) .
• Aklãdɔléle
• Megaloblastic anemia (le vitamin B12 alo folate ƒe anyimanɔmanɔ ta) .
• `(Myelofibrosis)`
• Aɖi (e.g. lifi) .
• Alesi wowɔa nui ne wodo ʋu nɛ
• Alesi wowɔa nui ne woɖe aɖuɖɔtoe ɖa
• Da ƒe ɖuɖu

Kuxi kawoe esia ate ŋu ahe vɛ?

Woate ŋu akpɔ nɔnɔme geɖe siwo hea poikilocytosis vɛ gbɔ to atikewɔwɔ me, eye woate ŋu ada ɖewo keŋkeŋ. Gake ne womewɔ atike na wo o la, nɔnɔme aɖewo ate ŋu ava zu nu sesẽ eye woate ŋu ade woƒe agbe afɔku me gɔ̃ hã. Le kpɔɖeŋu me, ne ʋusɔgbɔdɔ le ŋuwò la, ɖeɖi ate ŋuwò ale gbegbe be màte ŋu awɔ wò gbesiagbedɔwo o. Ne ʋumenugbagbevi dzĩ siwo le lãmesẽ me bu na wò le ɣeyiɣi aɖe megbe la, ate ŋu ahe nɔnɔmewo abe ŋutinuwo ƒe dɔmawɔmawɔ nyuie ene vɛ .

Vevietɔ le ɖevi suewo gome la, ne ʋusɔgbɔdɔ si womekpɔ atike na o dzɔ la, ate ŋu akpɔ ŋusẽ ɖe woƒe tsitsi kple tsitsi dzi.

Eyata ne wò ɖɔkta nya nya nusi tututu gbɔ wò Poikilocytosis tso ko la, ana atike si hiã be woatsɔ axe mɔ ɖe kuxi siawo tɔgbe nu.

Aleke tututu nèwɔna dea dzesi esia? (Dɔléle ƒe dzesi) .

Dodokpɔ vevitɔ si ɖɔkta ate ŋu azã atsɔ anya poikilocytosise nye ʋu si woɖena le lãme na ame (PBS) . Esia bia be dodokpɔxɔ me dɔwɔla aɖe naɖe wò ʋu ƒe akpa aɖe ahalé ŋku ɖe eŋu le nusuekpɔmɔ̃ me. Emegbe woate ŋu akpɔ wò ʋumenugbagbevi dzĩwo ƒe nɔnɔme si wɔ nuku kple nɔnɔme si ƒomevi wole.

Lãmenugbagbevi ƒomevi aɖewo bɔ ɖe dɔléle ƒe nɔnɔme aɖewo koŋ me wu. Gake le dɔléle ƒe nɔnɔme ɖeka me gɔ̃ hã la, lãmenugbagbevi ƒomevi vovovowo ate ŋu anɔ anyi. Le kpɔɖeŋu me, le nɔnɔmewo abe `(Hemolytic Anemia)`, `(Megaloblastic Anemia)`, `(Myelofibrosis)`, `(Thalassemia)` ene me la, woate ŋu akpɔ lãmenugbagbevi ƒomevi geɖe siwo mesɔ o.

Ðewohĩ ahiã be wò ɖɔktawo nawɔ dodokpɔ bubu aɖewo be woanya nusi tututu gbɔ wò poikilocytosis tso.

Dodokpɔ bubuwo be woakpɔ nusi gbɔ `(Poikilocytosis)` tso

Zi geɖe la, wowɔa ʋudodo blibo (CBC) kpe ɖe PBS ŋu. CBC ate ŋu ana nyatakaka geɖe tso lãmenugbagbevi siwo le wò ʋu me ŋu, eye woƒe agbɔsɔsɔ kple woƒe lolome hã le eme. Asixɔxɔ siwo le CBC me dometɔ aɖewo ate ŋu ana nyatakaka geɖe tso ʋumenugbagbevi dzĩwo ŋu, si ate ŋu akpe ɖe ame ŋu woanya nusi gbɔ Poikilocytosis tso. Dzidzenu siawo dometɔ aɖewoe nye:

• `Mean Corpuscular Volume (MCV)` : Wò ʋumenugbagbevi dzĩwo ƒe lolome le mama dedie nu.
• `Mean Corpuscular Hemoglobin (MCH)` : Hemoglobin ƒe agbɔsɔsɔ si le wò ʋumenugbagbevi dzĩwo me le mama dedie nu.
• ``Hemoglobin ƒe agbɔsɔsɔme si le lãmekawo me (MCHC)''.: Hemoglobin ƒe agbɔsɔsɔ si le wò ʋumenugbagbevi dzĩwo me ƒe asixɔxɔ le mama dedie nu.
• `Red Cell Distribution Width (RDW)` : Aleke wò ʋumenugbagbevi dzĩwo ƒe lolome to vovoe.

Tsɔ kpe ɖe eŋu la, wò ɖɔkta ate ŋu alé ŋku ɖe wò vitamin B12, folate, kple iron ƒe agbɔsɔsɔ ŋu, eye ate ŋu aɖe gbe hã be woado aklã ƒe dɔwɔwɔ kpɔ.

Nukawoe nye atike siwo wozãna na esia?

Atikewɔwɔ nɔ te ɖe nusi gbɔ wò poikilocytosis tso kple alesi wò dzesiawo nu sẽe dzi.

Ðo ŋku edzi be ne nusi gbɔ nɔnɔme sia tsoe nye nunyiame ƒe veve (e.g. iron, vitamin B12 ƒe anyimanɔmanɔ), nunyiame kpeɖeŋutɔ siwo sɔ nono, alo tɔtrɔ ɖe nuɖuɖu si me vitamin B12 alo folate sɔ gbɔ ɖo ŋu la, ate ŋu akpɔ `(Poikilocytosis)` nɔnɔme sia gbɔ zi geɖe.

Nɔnɔme geɖe siwo wodzina hiã be woalé ŋku ɖe wo ŋu nyuie . Ðewohĩ ahiã be woado ʋu na wò edziedzi be nàkpɔ egbɔ be ʋumenugbagbevi dzĩ siwo le lãmesẽ me sɔ gbɔ na wò. Alo ɖewohĩ ɖeko wòahiã be woawɔ atike na wò nenye be dzesiwo le ŋuwò.

Ðe woate ŋu axe mɔ ɖe nɔnɔme sia nua?

Míate ŋu axe mɔ ɖe nusiwo gbɔ ``Poikilocytosis'' tsona dzidzi nu o.`` Ke hã, míate ŋu aɖe afɔku si le nusiwo gbɔ wòtsona dometɔ aɖewo siwo dzea egɔme emegbe me dzi akpɔtɔ.

Mɔ nyuitɔ siwo dzi nàto alé be na wò ʋumenugbagbevi dzĩwo dometɔ ɖekae nye be nàkpɔ nunyiame siwo wò ŋutilã hiã be wòawɔ wo. Kpɔ egbɔ be vitamin B, folate, kple iron sɔ gbɔ na ye . Esiawo nye nu vevi siwo wò ŋutilã hiã be wòawɔ ʋumenugbagbevi dzĩ siwo le lãmesẽ me. Ekpena ɖe ame ŋu hã be nàɖe aha agbɔsɔsɔme si nènona dzi akpɔtɔ . Ahanono fũ ate ŋu ana wòasesẽ na wò ŋutilã be wòaxɔ nunyiame siawo.

Nukae etsɔme ahe vɛ? (Nukpɔsusu) .

Le goawo katã me la, ne nusi gbɔ `(Poikilocytosis)` tso nye nɔnɔme si dzea egɔme emegbe la, zi geɖe la, ŋgɔdonya la nyona. Le nusiwo gbɔ wòtso siwo wodzina gome la, nusiwo wogblɔ ɖi la toa vovo le nɔnɔme si gbɔ wòtso nu. Le kpɔɖeŋu me, togbɔ be wobua amesiwo ŋu `(Sickle Cell Disease)` ƒe agbenɔƒe le zi geɖe be ele kpuie hã la, atikewɔwɔ yeyewo na woate ŋu anɔ agbe ƒe 50 kple edzivɔ fifia esime wole dzesiawo dzi ɖum.

Ɣekaɣie wòle be nàkpɔ ɖɔkta?

Ne ʋusɔgbɔdɔ ƒe dzesiwo le ŋuwò (nu siwo ŋu míeƒo nu tsoe va yi, abe ɖeɖiteameŋu kple gbɔdzɔgbɔdzɔ ene) la, yi ɖɔkta gbɔ godoo.

Ne èse le ɖokuiwò me be yele lãmesẽ me eye dzesi aɖeke mele ŋuwò o hã la, ele vevie be nàdo wò kpɔ ƒe sia ƒe. Wò ɖɔkta ate ŋu alé ŋku ɖe wò ʋumenugbagbeviɣiwo hã ŋu. Ʋudodokpɔ bɔbɔe, abe ʋudodo blibo (CBC) ene, ate ŋu akpe ɖe ame ŋu wòade dzesi lãmesẽkuxiwo ahada wo hafi woava zu nu sesẽ.

Ðe ``Poikilocytosis'' sia nye nɔnɔme sesẽ aɖea?

`(Poikilocytosis)` ŋutɔ menye nu vevi o. Ke hã, e...Ate ŋu anye atikewɔwɔ me nɔnɔme aɖe si le ete si ate ŋu ahe kuxiwo vɛ ne womewɔ atike nɛ o la ƒe dzesi. Eyata ele vevie be woase nusi tututu le `(Poikilocytosis)` hem vɛ gɔme eye woadi atikewɔwɔ ne ehiã.

Poikilocytosis ate ŋu aɖi nɔnɔme sesẽ aɖe, gake menye nenemae o. Ðeko wònye wò ʋumenugbagbevi dzĩwo ƒe nɔnɔme aɖe si ɖɔktawo zãna tsɔ daa wò lãmesẽ kpɔna. Ne èkpɔe be yeƒe ʋumenugbagbevi dzĩwo mesɔ o la, mègahe ɖe megbe le nyabiabia wò ɖɔkta tso eŋu o. Ate ŋu agblɔ na wò ne ele ŋusẽ kpɔm ɖe wò lãmesẽ dzi eye ne ele ŋusẽ kpɔm ɖe edzi la, nusi nàte ŋu awɔ atsɔ aɖe dɔlélea ɖa alo akpɔ nɔnɔme si gbɔ wòtso gbɔ.

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

Enyo, eyata, nya vevi siwo dzi wòle be míaɖo ŋkui tso nusiwo ŋu míeƒo nu tsoe me enye esiawo:

• Poikilocytosis nye ne wò ʋumenugbagbevi dzĩwo ƒe nɔnɔme si wu 10% ƒe nɔnɔme mesɔ o.
• Esia menye dɔléle o, gake ate ŋu anye nɔnɔme aɖe si gbɔ wòtso ƒe dzesi.
• Woate ŋu akpɔ ʋusɔgbɔdɔ ƒe dzesiwo (ɖeɖiteameŋu, gbɔdzɔgbɔdzɔ, blɔ) hã le go sia me.
• Nusiwo gbɔ wòtso ate ŋu anye esiwo wodzina alo esiwo woxɔ (nunyiame ƒe veve, dɔléle aɖewo).
• Woateŋu ade dzesi esia to ʋudodokpɔ bɔbɔe (`PBS`, `CBC`) me.
• Atikewɔwɔ nɔ te ɖe nusi gbɔ wòtso dzi, gake zi geɖe la, woate ŋu akpɔ egbɔ.
• Nuɖuɖu nyui me léle ɖe asi ate ŋu akpe ɖe ame ŋu be woaxe mɔ ɖe nusiwo gbɔ wòtsona be wodzea egɔme emegbe dometɔ aɖewo nu.
• Ne dzesiwo le ŋuwò alo ɖikeke aɖe le mewò le esia ŋu la, anyo wu be nàyi ɖɔkta gbɔ aɖaɖo aɖaŋu na wò.

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

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