Ke luhi mau nei hoʻi ʻoe? Ke poniuniu nei ʻoe ma hope o ka hele wāwae ʻana no kekahi manawa? Ke loli nei kou ʻili i kekahi manawa a melemele ke ʻano? Hiki i kēia ke lilo i mau hōʻailona o ka anemia maʻamau. Akā i kekahi manawa aia kahi moʻolelo paʻakikī ma hope ona. He kūlana kakaikahi kahi e hoʻomaka ai ka ʻōnaehana pale ponoʻī o kou kino i ke kaua kūʻē i kou mau hunaola koko ponoʻī. ʻO ia ka mea a mākou e kamaʻilio nei i kēia lā.
He aha ka Anemia Hemolytic Autoimmune (AIHA)?
I ka ʻōlelo maʻalahi, ʻo ka Autoimmune Hemolytic Anemia (AIHA) kahi kūlana kahi e hoʻouka hewa ai ka ʻōnaehana pale o ko mākou kino a luku i ko mākou mau hunaola koko ʻulaʻula ponoʻī.
E noʻonoʻo e pili ana i ia mea, ʻo ko kākou mau hunaola koko ʻulaʻula he mau kaʻa liʻiliʻi e lawe ana i ka oxygen ma ke kino holoʻokoʻa. Hana ʻia lākou ma kahi hale hana i kapa ʻia ʻo ka iwi ʻiʻo i loko o ko kākou mau iwi. Ma ka awelika, ola kahi hunaola koko ʻulaʻula no kahi o 120 mau lā.
Akā i loko o ke kanaka me AIHA, ʻike ka ʻōnaehana pale, e like me ka ʻōnaehana pale o ke kino, i kēia mau hunaola koko ʻulaʻula e like me nā hunaola ʻenemi. A laila, hopu a luku kēia mau ʻōnaehana pale, ʻo ia hoʻi nā antibodies, i kēia mau hunaola koko ʻulaʻula. ʻOi aku ka wikiwiki o kēia luku ʻana ma mua o ka hiki i ka iwi iwi ke hana i nā hunaola koko ʻulaʻula hou. I kekahi manawa, ua luku ʻia kahi hunaola i manaʻo ʻia e ola no 120 mau lā i loko o kekahi mau lā wale nō. No laila, ʻaʻole loaʻa i ke kino ka nui o ka oxygen e pono ai a hoʻomaka nā hōʻailona e like me ka luhi a me ka nāwaliwali e ʻike ʻia.
He aha nā ʻano nui o AIHA?
Ua māhele nui ʻia ka AIHA i ʻelua ʻano, ma muli o ke ʻano o ka pane ʻana o ke kino i ka mahana.
- ʻO ka Anemia Hemolytic Autoimmune Wela: ʻO kēia ke ʻano maʻamau. I kēia, hoʻopau ka ʻōnaehana pale i nā hunaola koko ʻulaʻula ma ka mahana o ke kino maʻamau a i ʻole ma luna. Hoʻokumu ʻia kēia e kahi ʻano antibody kikoʻī i kapa ʻia ʻo IgG.
- ʻO ka Anemia Hemolytic Autoimmune Anu (Maʻi Agglutinin Anu - CAD): He ʻano kakaikahi loa kēia. I kēia, ua luku ʻia nā hunaola koko ʻulaʻula ke hōʻike ʻia ke kino i ke anu. ʻO ka maʻamau ma nā mahana haʻahaʻa e like me 3-4 degere Celsius. Hoʻokumu ʻia kēia e kahi ʻano antibody i kapa ʻia ʻo IgM.
ʻO ka mea nui, ʻaʻole kēia he maʻi lele. ʻAʻole hiki iā ʻoe ke loaʻa mai kekahi mea ʻē aʻe, a ʻaʻole hiki iā ʻoe ke hoʻolaha iā ia i kekahi. Eia nō naʻe, hiki ke lele kekahi o nā maʻi viral e hiki ai ke hoʻoulu i kēia maʻi.
He aha nā hōʻailona o kēia maʻi?
Ua like ka nui o nā hōʻailona o AIHA me nā hōʻailona o ka anemia maʻamau. ʻAʻole paha i loaʻa i kekahi poʻe kekahi mau hōʻailona.
| Hōʻailona | Wehewehena |
|---|---|
| Luhi a me ka nāwaliwali | ʻO ka hōʻailona maʻamau ka nele o ka oxygen i loko o ke kino. |
| Ka wikiwiki o ka puʻuwai (Tachycardia) | No ka mea, hana wikiwiki ka puʻuwai e hoʻoponopono i ka nele o ka oxygen. |
| Ka paʻakikī o ka hanu ʻana (dyspnea) | ʻOi loa aku i ka hana ʻana i nā hana liʻiliʻi a i ʻole ka hele wāwae ʻana. |
| Keʻokeʻo a melemele paha o ka ʻili a me nā maka (Jaundice) | ʻO Bilirubin, kahi mea i hana ʻia i ka wā e haki ai nā hunaola koko ʻulaʻula, ke kumu o ka melemele o ka ʻili a me nā keʻokeʻo o nā maka. |
| Mimi ʻeleʻele | He mimi i like ke kala me ka wai tī a i ʻole ka cola. |
| ʻO ka spleen i hoʻonui ʻia | Hiki i ka ʻōpū ke pehu a pehu paha i ka wā e hana ana i ka manawa ʻoi aku e wehe i nā hunaola koko ʻulaʻula i hōʻino ʻia. |
| Eia kekahi, ʻo ka poʻe me Cold AIHA (CAD)... | |
| Nā lima a me nā wāwae anu a me ke kala ʻole o ke kala | Ka loli ʻana o ke ʻano polū a ʻulaʻula paha o nā manamana lima a me nā manamana wāwae ke hōʻike ʻia i ke anu. |
| ʻEha poʻo a me ke kua | Hiki i ke anu ke hoʻopilikia i ke kahe koko. |
He aha ke kumu o ka AIHA?
I kekahi manawa, ʻaʻole hiki ke loaʻa ke kumu kikoʻī. Kāhea mākou i kēia ʻo Primary AIHA. Akā, ʻoi aku ka pinepine hiki ke hana ʻia e kekahi maʻi a lāʻau lapaʻau ʻē aʻe (Secondary AIHA).
Aia kekahi mau kumu nui:
- Nā maʻi autoimmune ʻē aʻe: ʻO ka poʻe me nā maʻi autoimmune ʻē aʻe, e like me lupus, aia i ka pilikia o ka hoʻomohala ʻana i ka AIHA.
- Kekahi mau ʻano maʻi kanesa: ʻoi aku hoʻi nā maʻi kanesa e pili ana i ke koko e like me ka Chronic Lymphocytic Leukemia a me Non-Hodgkin Lymphoma .
- Nā maʻi viral a me bacteria: Nā maʻi e like me ka maʻi Epstein-Barr (ka maʻi e hoʻoulu ai i ka mononucleosis, e like me ke anu), Cytomegalovirus , HIV , a me Mycoplasma pneumoniae .
- Kekahi mau lāʻau lapaʻau: Hiki i kekahi mau antibiotics (e.g., penicillin) a me nā lāʻau lapaʻau ʻē aʻe ke hana i kēia maʻi. No laila, he mea nui loa e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei.
Pehea ʻoe e ʻike ai inā loaʻa iā ʻoe ka AIHA?
Inā loaʻa iā ʻoe kēia mau hōʻailona, e ʻike pono i kāu kauka . E nīnau ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona, nā lāʻau lapaʻau āu e lawe nei, a e nānā iā ʻoe. Inā pono, e kuhikuhi lākou iā ʻoe i kahi hematologist.
Hana nui ʻia kekahi mau hoʻāʻo koko e hōʻoia i ka AIHA.
- Helu Koko Piha (CBC): Nānā kēia i kāu mau helu koko ʻulaʻula, nā keʻokeʻo, a me nā platelet. ʻO ka helu koko ʻulaʻula haʻahaʻa he hōʻailona ia o ka anemia.
- ʻO ka Peripheral Smear: Ua nānā ʻia kahi hāpana koko ma lalo o kahi microscope e ʻike i ke ʻano o nā hunaola koko ʻulaʻula a inā ua hōʻino ʻia.
- Helu Reticulocyte: Ke ana kēia i ka helu o nā hunaola koko ʻulaʻula ʻōpiopio i hana ʻia e ka iwi iwi. Inā kiʻekiʻe kēia helu, ʻo ia hoʻi ke hana nui nei ka iwi iwi e hana i nā hunaola hou e pani i nā mea e luku ʻia nei.
- Hoʻāʻo Coombs: ʻO kēia ka hoʻāʻo koʻikoʻi loa no ka ʻike ʻana i ka AIHA. Hiki iā ia ke hoʻoholo inā e hana ana kou kino i nā antibodies e kūʻē i nā hunaola koko ʻulaʻula.
- Nā hoʻokolohua ʻē aʻe: Eia kekahi, hiki ke hana ʻia nā hoʻokolohua e like me Bilirubin lāua ʻo Haptoglobin.
He aha nā lāʻau lapaʻau no AIHA?
Inā ʻaʻole koʻikoʻi kou kūlana, ʻaʻole paha ʻoe e pono i ka lāʻau lapaʻau. Eia nō naʻe, pono ʻoe e noho ma lalo o ka nānā mau ʻana a ke kauka. Inā he mau hōʻailona a inā koʻikoʻi ka anemia, e hoʻomaka ʻia ka lāʻau lapaʻau.
- Nā Steroid: ʻO nā steroid, e like me ka prednisolone, nā lāʻau lapaʻau mua. Hoʻopau kēia i ka ʻōnaehana pale ikaika a hoʻōki i ka luku ʻia ʻana o nā hunaola koko ʻulaʻula.
- Nā lāʻau lapaʻau ʻē aʻe e kaohi ana i ka ʻōnaehana pale kino (Immunosuppressants): Inā ʻaʻole pane ka maʻi i nā steroids, hoʻohana ʻia nā lāʻau lapaʻau e like me Rituximab lāua ʻo Azathioprine.
- Splenectomy: I nā hihia kahi i kūpono ʻole ai ka lāʻau lapaʻau, ʻoiai ma ka AIHA mahana, ʻo ka spleen, kahi o ka hapa nui o ka luku ʻia ʻana o nā ʻula koko ʻulaʻula, e wehe ʻia ma ke ʻoki ʻana.
- Ka Hoʻoili Koko: Inā koʻikoʻi loa ka anemia a hoʻoweliweli i ke ola, pono paha ka hoʻoili koko.
- Nā wikamina a me nā mea hoʻohui meaʻai: Hiki i kāu kauka ke ʻōlelo aku i nā mea e like me ka waikawa folic, ka mea e pono ai no ka hana ʻana i nā hunaola koko ʻulaʻula. Mai lawe i kekahi wikamina me ka ʻole o ke kūkākūkā ʻana me kāu kauka.
ʻŌlelo aʻoaʻo kūikawā no ka poʻe me ke Anu AIHA
Inā he ʻano maʻalahi kou i ke anu, he mea nui loa ia e pale iā ʻoe iho mai ke anu .
- E komo i nā mīkina lima i ka wā e lawe ai i nā mea mai loko mai o ka pahu hau a i ʻole ka pahu hau.
- I ke hele ʻana i waho i nā lā anuanu, e ʻaʻahu maikaʻi, e komo i ka pāpale, a me kahi sick cover.
- Mai hoʻohaʻahaʻa loa i ka AC ma ka home.
- Ma mua o ke komo ʻana i loko o ke kaʻa i kahi lā anuanu, e hoʻomaka no kekahi manawa a e hoʻomehana i loko o ke kaʻa.
He aha nā pilikia e hiki mai ana inā ʻaʻole mālama ʻia?
Inā ʻaʻole i kāohi ʻia ka AIHA, hiki ke loaʻa nā pilikia koʻikoʻi.
- Nā ʻAʻa Koko: Aia kahi pilikia kiʻekiʻe o nā ʻaʻa koko, ʻoi aku hoʻi ma nā wāwae a me nā māmā. Hiki i kahi ʻaʻa koko i loko o nā māmā (Pulmonary Embolism) ke hoʻoweliweli i ke ola.
- Maʻi puʻuwai: Hiki i ka anemia lōʻihi ke hoʻonāwaliwali i ka puʻuwai no ka mea e hana ikaika ka puʻuwai.
- Ka pōʻino o nā puʻupaʻa: ʻO ka luku nui ʻana o nā hunaola koko ʻulaʻula hiki ke hōʻino i nā puʻupaʻa.
Leka Lawe-Home
- ʻO ka Autoimmune Hemolytic Anemia (AIHA) kahi kūlana kahi e hoʻopau hewa ai kāu ʻōnaehana pale ponoʻī i kou mau keʻena koko ʻulaʻula.
- Inā loaʻa iā ʻoe nā hōʻailona e like me ka luhi koke, ka poniuniu, a i ʻole ka melemele o ka ʻili a i ʻole nā maka, mai hoʻowahāwahā iā ia a e ʻike koke i ke kauka.
- ʻAʻole kēia he maʻi lele. No laila, ʻaʻohe pono e hoʻokaʻawale a makaʻu paha i ka mea maʻi.
- ʻOiai ʻaʻole hiki ke ho'ōla loa ʻia kēia maʻi, aia nā lāʻau lapaʻau kūpono loa e hiki ke kōkua i ka kaohi ʻana i ka maʻi a ʻae iā ʻoe e ola i kahi ola maʻamau.
- He mea nui loa e hahai pololei i nā ʻōlelo a ke kauka, e lawe i kāu lāʻau lapaʻau e like me ke kauoha, a e ʻai i nā meaʻai momona.
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