He haʻahaʻa loa anei kou mau keʻokeʻo koko? ʻO ka agranulocytosis anei kēlā? E kamaʻilio kākou e pili ana!

Ke maʻi mau nei ʻoe? Ke manaʻo nei ʻoe ua nāwaliwali a luhi hoʻi no kekahi manawa pōkole? I kekahi manawa hiki ke kumu o kēia ma muli o ka emi ʻana o ka pale o kou kino, ʻo ia hoʻi nā neutrophils, kahi ʻano o ke koko keʻokeʻo. I kēia lā ke kamaʻilio nei mākou e pili ana i kahi maʻi koʻikoʻi akā hiki ke mālama ʻia i kapa ʻia ʻo agranulocytosis . Mai hopohopo, he mea nui e makaʻala i kēia.

He aha ka agranulocytosis maoli?

I ka ʻōlelo maʻalahi, ʻo Agranulocytosis kahi kūlana hoʻoweliweli ola kahi e hāʻule ai ka helu o nā hunaola koko keʻokeʻo i kapa ʻia ʻo neutrophils i loko o ko mākou kino i kahi pae haʻahaʻa loa. Ua ʻike anei ʻoe he like nā hunaola koko keʻokeʻo me nā koa i loko o kā mākou ʻōnaehana pale? ʻO lākou ka poʻe e pale iā mākou mai nā germs e hoʻoulu ai i ka maʻi. Ke emi ka helu o kēia mau neutrophils, lilo ko mākou kino i mea maʻalahi i nā germs. ʻOiai nā germs i hana ʻole i ka pōʻino nui iā mākou hiki ke hoʻomaʻi iā mākou. E noʻonoʻo, inā nalowale koke kahi hui pūʻali koa kūikawā i loko o ka pūʻali koa o ko mākou ʻāina, ʻaʻole anei he pilikia nui kahi ʻenemi liʻiliʻi? Pēlā nō kēia. Loaʻa ka inoa "agranulocytosis" mai ka huaʻōlelo granulocytes . ʻO Granulocytes kekahi ʻano o nā hunaola koko keʻokeʻo. Loaʻa iā lākou nā enzymes e luku i nā germs. ʻEkolu ʻano o nā granulocytes: Neutrophils , Eosinophils, a me Basophils . ʻO Neutrophils nā hunaola koko keʻokeʻo nui loa i loko o ko mākou kino. ʻO ia ke kumu e hoʻāʻo ai nā kauka i nā pae neutrophil e ʻike i ka agranulocytosis. I kekahi manawa ua kapa ʻia kēia he granulocytopenia .

He aha ka ʻokoʻa ma waena o Neutropenia a me Agranulocytosis?

Ua pili nā mea ʻelua me ka emi ʻana o nā neutrophils. Eia nō naʻe, ʻo ka agranulocytosis ke ʻano koʻikoʻi loa o ka neutropenia .

• ʻO ka Neutropenia kahi kūlana i emi ai ka nui o nā neutrophils i loko o ke koko ma mua o ka maʻamau. ʻO ka poʻe me ka emi ma mua o 1,500 neutrophils i kēlā me kēia microliter (mL) o ke koko ua ʻōlelo ʻia he neutropenia.
• ʻO Agranulocytosis ka pae hope loa a weliweli loa, i ka wā e hāʻule ai ka helu neutrophil ma lalo o 100 no ka microliter o ke koko. Ua maopopo iaʻu? ʻO kēia ke ʻano koʻikoʻi loa o ka neutropenia.

Aia kekahi mau ʻano o ka agranulocytosis?

ʻAe, hiki i kēia ke hele mai ma nā ʻano nui ʻelua: 1. Agranulocytosis hoʻoilina:Hoʻokumu ʻia kēia e kahi maʻi hoʻoilina. ʻO ia hoʻi, aia kahi pilikia me nā genes e kōkua i ko mākou kino e hana i nā neutrophils. Hoʻopilikia nui kēia kūlana i nā pēpē a me nā kamaliʻi liʻiliʻi. 2. ʻO ka agranulocytosis i loaʻa: Hiki i kēia ke loaʻa nā kumu he nui. Eia nō naʻe, ʻo ka hapa nui o ka manawa (ma kahi o 70% o ka manawa!) ua hoʻokumu ʻia e kahi hopena ʻaoʻao o kekahi lāʻau lapaʻau a mākou e lawe ai. ʻO kēia ʻano ka mea maʻamau i nā pākeke.

Pehea ka maʻamau o kēia ʻano?

He maʻi laha ʻole kēia. Ma ka awelika, ma kahi o ʻehiku mau kānaka mai kēlā me kēia haneli tausani e loaʻa i kēia maʻi i kēlā me kēia makahiki. No laila, mai makaʻu pono ʻole, akā he mea nui e makaʻala.

He aha nā hōʻailona o ka Agranulocytosis?

I kēia hihia, pili nā hōʻailona nui i nā maʻi. Hiki ke hoʻomaka koke kēia mau mea, a i ʻole hiki ke hoʻonui mālie i ka hala ʻana o ka manawa. E nānā inā kamaʻāina kēia mau hōʻailona iā ʻoe:

• Ke loaʻa nei ke kuni, ke anu a me ka haʻalulu.
• Hoʻonui ʻia ka helu o ka puʻuwai a me ka hanu ʻana.
• Manaʻo o ke ola ʻole a me ka luhi nui.
• ʻEha ka ʻāʻī (pharyngitis), ka haki ʻana o ka gingival, ke kahe ʻana o ke koko o nā ʻāʻī.
• Nā ʻeha ma ka waha a me ka puʻu, e paʻakikī ai ke ale i ka meaʻai a me ka mea inu.
• Haʻahaʻa koke ke koko (hypotension), poniuniu, maule, a malia paha e nalowale ana ka ʻike.

Inā loaʻa iā ʻoe nā hōʻailona e like me kēia, ʻoiai inā pinepine lākou, pono ʻoe e ʻimi i ke kōkua lapaʻau.

No ke aha e hana ai ka agranulocytosis? He aha nā kumu?

ʻO ke kumu nui o kēia, ʻo ia ka emi ʻana o ka nui o nā hunaola koko keʻokeʻo i kapa ʻia he neutrophils i loko o ko kākou kino. ʻElua mau kumu kūpono no kēia:

• ʻAʻole lawa ka neutrophils o ko mākou kino e hana pono ai.
• A i ʻole, e luku ʻia nā neutrophils i loko o ke kino, a make paha lākou i ka wā ʻōpiopio.

I kēia manawa, e nānā kākou i nā kumu kikoʻī no kēia.

ʻO ka agranulocytosis hoʻoilina

Ma kēia, aia kahi pilikia me kahi gene e kōkua ana i ka hana ʻana i nā neutrophils. He kūlana kēia i loaʻa i ka wā hānau (congenital). No ka laʻana, inā mākou e lawe i ka Kostmann syndrome , a i ʻole congenital agranulocytosis , kahi kūlana kakaikahi, loaʻa pinepine i nā pēpē hānau hou nā maʻi, ke kuni, ka mumū, a me nā pilikia iwi.

ʻO ka agranulocytosis i loaʻa

Aia paha he nui nā kumu no kēia. E nānā kākou i ko lākou ʻano:

• Kekahi mau lāʻau lapaʻau: ʻO kēia ke kumu maʻamau . Hiki i kekahi mau antibiotics , nā lāʻau antipsychotic , a me nā lāʻau thyroid ke hana i kēia maʻi.
• Nā maʻi Autoimmune : ʻO kēia nā maʻi kahi e hoʻouka ai ka ʻōnaehana pale i nā hunaola ponoʻī o ke kino. ʻO nā hiʻohiʻona e komo pū me ka lupus a me ka rheumatoid arthritis .
• Nā maʻi iwi ʻiwi a me nā maʻi hāʻule ʻana o ka iwi ʻiwi: No ka laʻana , ka anemia aplastic . ʻO ka iwi ʻiwi kahi i hana ʻia ai ko mākou mau hunaola koko.
• Kanesa: Nā maʻi kanesa e hoʻopilikia ana i ka iwi iwi, ʻoiai ka leukemia .
• Nā lāʻau lapaʻau no ke kanesa (Chemotherapy): Hiki i kēia mau lāʻau lapaʻau ke luku i nā hunaola olakino a me nā neutrophils.
• Ka ʻike ʻia ʻana i nā mea ʻawahia a i ʻole nā ​​​​kemika: Ka ʻike lōʻihi ʻia ʻana i nā mea e like me ke kēpau a i ʻole ka mercury.
• Nā maʻi: Nā maʻi koʻikoʻi e like me ka malaria , ka maʻi puʻupuʻu , a me ka Rocky Mountain spotted fever .
• Nā hemahema meaʻai: ʻAʻole lawa nā meaola koʻikoʻi e like me ka Vitamin B12 a me ka Folate.

ʻO wai ka mea i pilikia nui no kēia maʻi?

ʻOi aku ka nui o ka loaʻa ʻana o kēia maʻi i nā wahine ma mua o nā kāne. Eia kekahi, hiki i ka agranulocytosis ke hoʻopilikia i kekahi o kēlā me kēia makahiki. Eia nō naʻe, aia kēia poʻe i ka pilikia nui:

• ʻO nā kānaka e hana ana i ka chemotherapy no ka maʻi kanesa.
• ʻO nā kānaka me nā maʻi autoimmune e like me ka lupus a me ka rheumatoid arthritis .
• ʻO ka poʻe e lawe ana i kekahi mau lāʻau lapaʻau, e like me Clozapine (Clozaril®) , kahi antipsychotic , Trimethoprim/sulfamethoxazole (Bactrim™) , a me Methimazole (Tapazole®), kahi lāʻau lapaʻau thyroid.

He aha nā pilikia e hiki ke kū mai ma muli o ka agranulocytosis?

Hiki i kēia kūlana ke alakaʻi i nā maʻi pinepine a lōʻihi paha (nā maʻi maʻi mau).

Inā hoʻomau ka agranulocytosis no nā pule he ʻekolu a ʻehā paha, aia kahi 100% manawa e loaʻa ai kahi maʻi.

Inā ʻaʻole mālama ʻia, hiki i ka sepsis ke alakaʻi i kahi hopena koʻikoʻi o ka ʻōnaehana pale e hoʻoweliweli i ke ola i kapa ʻia ʻo sepsis. He maʻi koʻikoʻi ka Sepsis e laha ana ma ke kino holoʻokoʻa. ʻO ka poʻe ma luna o 65 mau makahiki a i ʻole ka poʻe me nā pilikia olakino ʻē aʻe, e like me ka maʻi puʻuwai, ka maʻi puʻupaʻa, a i ʻole ka maʻi māmā, ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o kēia mau pilikia.

Pehea ʻoe e ʻike ai i kēia?

Pehea e ʻike ai ke kauka i ka agranulocytosis? Hana pinepine lākou i kēia mau ʻanuʻu:

• Helu Koko Piha (CBC) a me ka ʻokoʻa: Nānā kēia hoʻāʻo i nā ʻano ʻokoʻa o nā cell i loko o kou koko, ʻoiai ka helu o nā neutrophils. ʻO ka helu neutrophil piha (ANC) ma lalo o 100 no ka microliter o ke koko ua manaʻo ʻia he agranulocytosis. (ʻOi aku ka waiwai maʻamau no ke kanaka olakino ma mua o 1,500.)
• ʻO ka biopsy iwi a me ka aspirate: I kekahi manawa, hiki ke hana ʻia kēia hoʻāʻo e ʻike pehea e hana ai kou iwi iwi i nā neutrophils.
• Nā hōʻailona a me ka mōʻaukala lapaʻau: E nīnau ke kauka iā ʻoe e pili ana i kāu mau hōʻailona, ​​​​nā lāʻau lapaʻau āu e lawe ai, nā maʻi i hala koke nei, a me kekahi ʻike ʻana i nā kemika.
• Hoʻāʻo ʻana i ka genetic: Inā kānalua ʻia kahi maʻi genetic, hiki ke hana ʻia nā hoʻāʻo genetic e hōʻoia iā ia. Hiki i kēia ke pili i kahi biopsy ʻili a i ʻole kahi hoʻāʻo koko.

He aha nā lāʻau lapaʻau no kēia?

ʻO ka nūhou maikaʻi, aia nā lāʻau lapaʻau no kēia ʻano, ʻo ia hoʻi ka agranulocytosis. Aia ka lāʻau lapaʻau i ke kumu.

• Ke Hoʻōki ʻana i ka Lāʻau Lapaʻau: Inā he lāʻau lapaʻau ke kumu o kāu mau hōʻailona, ​​ʻo ka mea mua e hana ai, ʻo ia ke hoʻōki palekana i ka lawe ʻana e like me ke kuhikuhi a kāu kauka. Mai hoʻōki i ka lawe ʻana i ka lāʻau lapaʻau me ka ʻole o ke kūkākūkā ʻana me ke kauka.
• Nā lāʻau lapaʻau: Inā loaʻa iā ʻoe kahi maʻi, e kuhikuhi kāu kauka i nā lāʻau lapaʻau kūpono a me nā lāʻau lapaʻau ʻē aʻe e hōʻemi i nā hōʻailona.
• ʻO ka Granulocyte colony-stimulating factor (G-CSF): Hiki ke hāʻawi ʻia kēia ʻano inikini e kōkua i ke kino e hana koke i nā neutrophils. ʻO nā laʻana e komo pū me nā lāʻau lapaʻau e like me Filgrastim (Neupogen®) , Pegfilgrastim (Neulasta®) , a me Lenograstim (Granocyte®) .
• Nā Immunosuppressants: Inā loaʻa ke ʻano ma muli o kahi maʻi autoimmune, hiki ke kuhikuhi ʻia nā lāʻau lapaʻau e hoʻopau i ka ʻōnaehana pale, e like me Prednisone .
• Hoʻoili iwi iwi: Inā ʻaʻole holomua nā lāʻau ʻē aʻe, pono paha ʻoe e loaʻa i kahi hoʻoili iwi iwi. Ma kēia, e hāʻawi ʻia ʻoe i ka iwi iwi mai kahi mea hāʻawi olakino. E kōkua kēia i kou kino e hana hou i nā neutrophils olakino.
• Ke pale ʻana i nā maʻi: He mea nui loa kēia. Pono ka poʻe me kēia maʻi e makaʻala loa e pale aku i nā maʻi.
• E holoi mau i kou mau lima me ke kopa.
• E hōʻalo i nā wahi piha kanaka i ka hiki.
• E komo i ka uhi maka/mask i ka wā e puka ai i waho.
• E kamaʻilio me kāu kauka e pili ana i nā mea ʻē aʻe āu e hiki ai ke hana e pale aku ai i ka maʻi.

Pehea ka wikiwiki o koʻu ho'ōla ʻana ma hope o ka lāʻau lapaʻau?

ʻO ka manawa hoʻōla e pili ana i ke kumu o kou helu neutrophil haʻahaʻa a me ke koʻikoʻi o ke kūlana. Inā he hopena ʻaoʻao ia o kahi lāʻau lapaʻau, hiki ke hala i hoʻokahi pule a ʻekolu pule no ka hoʻi ʻana o kāu helu neutrophil i ka maʻamau ma hope o kou hoʻōki ʻana i ka lawe ʻana i ka lāʻau lapaʻau.

Hiki ke pale ʻia kēia?

I kekahi manawa, ʻaʻole hiki ke pale loa ʻia ka agranulocytosis. Eia nō naʻe, inā ʻoe e lawe ana i kahi lāʻau lapaʻau e hiki ke hoʻohaʻahaʻa i kāu neutrophils (e.g., chemotherapy, kekahi mau lāʻau lapaʻau psychiatric), he mea nui e kamaʻilio me kāu kauka a e nānā mau ʻia kāu mau pae neutrophil. Inā ʻoe e loaʻa ana i ka chemotherapy no ka maʻi ʻaʻai, hiki i kāu kauka ke ʻōlelo aku i kahi inikini G-CSF e kōkua i ka hoʻonui ʻana i ka hana neutrophil.

He aha ka manaʻolana no kekahi kanaka me ka agranulocytosis?

ʻOiai he maʻi hiki ke mālama ʻia kēia, hiki ke ʻokoʻa nā hopena mai kēlā kanaka a kēia kanaka. Me ka mālama kūpono, a inā ua hoʻōki ʻia ka lāʻau lapaʻau e hōʻemi ana i nā neutrophils, hoʻopau pinepine ʻia ke ʻano.

Eia nō naʻe, inā ʻaʻole mālama ʻia, hiki ke loaʻa nā maʻi koʻikoʻi a me ka make. ʻO ka lōʻihi o ka helu neutrophil e noho ana ma kahi pae weliweli, ʻoi aku ka nui o ka pilikia o ka maʻi a me nā pilikia. He ʻoiaʻiʻo loa kēia no ka poʻe ma luna o 65 a me ka poʻe me nā maʻi olakino (e like me ka maʻi puʻupaʻa, ka puʻuwai, a i ʻole ka maʻi māmā).

Āhea ʻoe e ʻike ai i ke kauka?

He maʻi hoʻoweliweli ola ka Agranulocytosis. No laila, he mea nui e loaʻa koke kahi hōʻailona a me ka lāʻau lapaʻau. E ʻike koke i ke kauka inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona:

• Inā loaʻa pinepine ʻoe i nā maʻi.
• Inā lōʻihi ka manawa e ho'ōla ai i ka maʻi.
• Inā loaʻa iā ʻoe nā hōʻailona o ka maʻi e like me ke kuni, ke anu, a i ʻole ka ʻeha ʻāʻī.

Inā loaʻa iā ʻoe kahi maʻi autoimmune a i ʻole ke lawe nei ʻoe i ka lāʻau lapaʻau e hoʻohaʻahaʻa i kāu neutrophils, mai haʻalele i kāu mau hoʻokolohua lapaʻau. Hiki i nā hoʻokolohua maʻamau me kāu kauka ke kōkua iā ʻoe e nānā i kāu mau pae neutrophil a kōkua i ka pale ʻana i nā maʻi.

Nā mea nui a mākou e hoʻomanaʻo ai (Leka Lawe-Home)

ʻAe, e hōʻuluʻulu kākou i kekahi o nā mea nui loa mai nā mea a mākou i kamaʻilio ai:

• He maʻi koʻikoʻi ka Agranulocytosis akā hiki ke mālama ʻia kahi e emi nui ai nā keʻokeʻo koko keʻokeʻo i kapa ʻia ʻo neutrophils.
• Inā loaʻa iā ʻoe nā hōʻailona e like me nā maʻi maʻi pinepine, ke kuni, a i ʻole ka ʻeha o ka puʻu, e ʻike koke i ke kauka.
• Hiki ke hana ʻia kēia e kekahi mau lāʻau lapaʻau, nā maʻi autoimmune, a me nā lāʻau lapaʻau maʻi kanesa.
• Hiki i ka lāʻau lapaʻau ke komo pū me ka hoʻōki ʻana i ka lāʻau hewa, nā lāʻau antibiotic, nā inikini G-CSF, a me ka hoʻoili ʻana paha i ka iwi iwi.
• He mea nui loa ka pale ʻana iā ʻoe iho mai nā maʻi. Hiki iā ʻoe ke pale iā ʻoe iho ma ka hana ʻana i nā mea maʻalahi e like me ka holoi pinepine ʻana i kou mau lima a me ke kau ʻana i ka pale maka i ka wā e hele ai i ka lehulehu.
• Inā ʻoe e pilikia ana no kēia (e.g., inā ʻoe e lawe i kekahi mau lāʻau lapaʻau), mai hōʻole i nā manawa i koho ʻia e ke kauka.

Manaʻolana wau he mea pono kēia ʻike iā ʻoe. E ola kino!