He mea koʻikoʻi anei ka luaʻi ʻana i ke koko? E aʻo kākou e pili ana i ka Hemolytic Uremic Syndrome (HUS)!

Ua loaʻa anei i kāu keiki liʻiliʻi ka maʻi pākī no kekahi mau lā? E makaʻu ana nā makuahine a me nā makuakāne āpau inā ʻike lākou i ke koko liʻiliʻi i loko o ko lākou ʻōpala? ʻO ka hapa nui o ka manawa, ua manaʻo ʻia he ʻeha ʻōpū maʻalahi ia, akā i kekahi manawa hiki ke lilo i hōʻailona mua o kahi maʻi koʻikoʻi. ʻO ia ka mea a mākou e kamaʻilio nei i kēia lā, ʻo Hemolytic Uremic Syndrome, a i ʻole HUS no ka pōkole, kahi maʻi koʻikoʻi e hiki ke hana, ʻoiai ma hope o ka maʻi me ka bacteria E. coli. E aʻo kākou e pili ana i kēia me ka maʻalahi a me ka pololei.

I ka ʻōlelo maʻalahi, he aha ʻo HUS?

E noʻonoʻo i nā kīʻaha koko ma loko o ko kākou kino e like me kahi pūnaewele o nā alanui. ʻO kēia mau alanui kahi e lawe ai ko kākou mau hunaola koko ʻulaʻula i ka oxygen ma loko o ke kino. Ma ke ʻano i kapa ʻia ʻo HUS, hana ʻia nā ʻūpā koko a paʻa i loko o nā kīʻaha koko liʻiliʻi (capillaries), ʻoi aku hoʻi i nā puʻupaʻa . Ua like ia me kahi paipu wai e paʻa ana i ka lepo a me ka wai.

Ke ālai ʻia nā kīʻaha koko ma kēia ʻano, ʻekolu mau mea nui e hana ʻia:

1. Anemia Hemolytic: ʻO nā hunaola koko ʻulaʻula e hoʻāʻo nei e hele ma waena o nā kīʻaha koko i ālai ʻia e paʻa, ʻūlū ʻia, a haki. Hoʻemi kēia i ka nui o ke koko i loko o ke kino, ʻo ia hoʻi ka anemia.

2. Ka emi ʻana o ka helu platelet (Thrombocytopenia): Hoʻohana ʻia kēia mau ʻāpana liʻiliʻi e kōkua ana i ke kāpili ʻana o ke koko i loko o nā ʻōpū koko e hana ʻia ana i loko o nā kīʻaha koko. ʻO ka hopena, emi ka helu maʻamau o nā platelet i loko o ke koko.

3. Ka Hāʻule ʻana o nā Puʻupaʻa: No ka mea, ʻaʻole lawa ke koko i nā puʻupaʻa a ua hōʻino ʻia nā kīʻaha koko, ʻaʻole hiki i nā puʻupaʻa ke kānana pono i nā ʻōpala mai ko mākou kino a hoʻokuʻu iā lākou ma ke ʻano he mimi. Hiki i kēia ke alakaʻi i ka hāʻule koke ʻana o nā puʻupaʻa.

He aha ke kumu nui o ka HUS?

ʻO ka hapa nui o ka manawa, ma kahi o 90% o ka manawa, ua hoʻokumu ʻia ka HUS e kahi bacteria i kapa ʻia ʻo E. coli (Escherichia coli), kahi e hana ai i kahi mea ʻawahia i kapa ʻia ʻo Shiga toxin . Komo kēia bacteria i loko o ko kākou kino ma o ka meaʻai lepo, moʻa pono ʻole a i ʻole ka wai haumia.

E noʻonoʻo i kēia hiʻohiʻona. Ke ʻai nei ʻoe ma kahi hale ʻaina me kou ʻohana. Inā ʻai ʻoe i ka pipi i moʻa ʻole ʻia (ʻoi aku ka pipi i wili ʻia), ka waiū a i ʻole ka tīhi i hoʻomaʻemaʻe ʻole ʻia, a i ʻole ka letus a i ʻole nā ​​​​mea kanu i holoi ʻole ʻia, hiki ke loaʻa iā ia ka bacteria E. coli.

Ke komo kēia bacteria i ke kino, hoʻoulu ia i ka ʻeha o ka ʻōpū a me ka maʻi kahe wai i loko o kekahi mau lā. I loko o hoʻokahi a ʻelua paha lā, lilo kēia i ka maʻi kahe koko.ʻO nā mea ʻawahia Shiga i hana ʻia e ka bacteria e hōʻino i nā paia o ko kākou ʻōpū a hoʻoulu i ke kahe ʻana o ke koko. A laila komo kēia mau mea ʻawahia i ke kahe koko a hele i loko o ke kino, e hōʻino ana i nā kīʻaha koko liʻiliʻi i loko o nā puʻupaʻa. Penei ka hoʻomaka ʻana o HUS.

Aia kekahi mau ʻano nui o HUS?

ʻAe, hiki ke hoʻokaʻawale ʻia ʻo HUS i kekahi mau ʻano nui.

• HUS "Maʻamau": ʻO kēia ke ʻano a mākou i kamaʻilio ai a hiki i kēia manawa, ʻo ka mea i hoʻokumu pinepine ʻia e kahi maʻi bacteria e like me E. coli.
• HUS ʻano ʻē (aHUS): He ʻano kakaikahi kēia. Hoʻokumu ʻia ia e kahi kīnā hoʻoilina. ʻO ia hoʻi, hiki ke hoʻoilina ʻia mai nā mākua a i nā keiki. Hiki i kēia poʻe ke loaʻa koke iā HUS, ʻoiai inā loaʻa iā lākou kahi mea e like me ke anu maʻamau a i ʻole ka maʻi palū.
• HUS Lua: Hana ʻia kēia ma ke ʻano he hopena ʻaoʻao o kekahi maʻi ʻē aʻe (e like me ke kanesa) a i ʻole kekahi mau lāʻau lapaʻau (e like me nā lāʻau anti-cancer, immunosuppressants).

He aha nā hōʻailona o HUS? Pehea e ʻike ʻia ai?

ʻIke pinepine ʻia nā hōʻailona o ka HUS i ʻelua pae. ʻO ka mua, ʻike ʻia nā hōʻailona e pili ana i ka maʻi ʻōpū. A laila, ʻike ʻia nā hōʻailona koʻikoʻi e pili ana i ka HUS.

Āhea ʻoe e ʻike koke ai i ke kauka?

Inā loaʻa iā ʻoe a i ʻole kāu keiki kēia mau hōʻailona, ​​​​pono ʻoe e hele koke i ka Emergency Department (ETU) o ka haukapila .

• Ka maʻi kahe e mau ana ma mua o ʻekolu lā.
• Ka maʻi kahe me ke koko.
• Inā emi nui ka nui o ka mimi āu e hoʻokuʻu ai.
• Inā he keʻokeʻo ke keiki a luhi loa.
• Inā pehu ke kino.

Pehea e hōʻoia ai nā kauka i ke kūlana HUS?

E hoʻolohe pono ke kauka nāna ʻoe e nānā i kāu mau hōʻailona a laila e kauoha i kekahi mau hoʻokolohua e hōʻoia i ka hōʻoia o HUS.

• Nā hoʻāʻo koko: Hiki i kēia ke nānā i ka helu haʻahaʻa o nā cell koko ʻulaʻula a me nā platelet, a me ka hana o nā puʻupaʻa (creatinine, urea, a pēlā aku).
• Urinalysis: Nānā i ke koko a i ʻole ka protein i loko o ka mimi.
• Hoʻāʻo ʻana i ka noho: Nānā i nā bacteria e like me E. coli O157 i loko o ka noho.
• ʻO ka Biopsy Kidney: I kekahi manawa, pono e lawe ʻia kahi ʻāpana liʻiliʻi o ka puʻupaʻa a hoʻāʻo ʻia e hōʻoia i ka maʻi.

He aha nā lāʻau lapaʻau no HUS?

He maʻi ʻo HUS e pono ai ka mālama ʻia ma ka haukapila . ʻAʻole hiki ke mālama ʻia ma ka home. ʻO kēia nā lāʻau lapaʻau nui i hāʻawi ʻia ma ka haukapila.

1. Hāʻawi i ka saline a me ka meaʻai: Hiki i ka maʻi kahe a me ka luaʻi ke hoʻoheheʻe i ka wai ma ka wehe ʻana i ka wai a me nā paʻakai mai ke kino. No ka pale ʻana i kēia, hāʻawi ʻia ka saline (nā wai IV) ma o kahi aa. Inā ʻaʻole hiki iā ʻoe ke ʻai, hāʻawi ʻia ka meaʻai ma o kahi ʻōmole.

2. Nā hoʻoili koko a me nā platelet:Hāʻawi ʻia ke koko inā haʻahaʻa loa ka helu o nā hunaola koko ʻulaʻula (anemia). Hāʻawi pū ʻia nā platelets inā haʻahaʻa loa ka helu o nā platelet a aia ka pilikia o ke kahe ʻana o ke koko.

3. Dialysis: Inā nāwaliwali loa nā puʻupaʻa e hoʻoneʻe i nā huahana ʻōpala mai ke kino, pono ka dialysis, kahi mīkini e hoʻomaʻemaʻe i ke koko. He hana manawa pōkole kēia. Hiki ke hoʻōki ʻia ka Dialysis ke hoʻomaka hou nā puʻupaʻa e hana.

4. Nā lāʻau lapaʻau kūikawā: No nā ʻano kakaikahi e like me ka HUS atypical (aHUS), hoʻohana ʻia nā lāʻau lapaʻau kūikawā e like me ka eculizumab a i ʻole ravulizumab .

He aha kā mākou e hana ai e pale aku ai iā HUS?

ʻO ke ala maikaʻi loa e pale aku ai i ka HUS, ʻo ia ka mālama ʻana i nā mea liʻiliʻi i ko kākou ola o kēlā me kēia lā.

• E holoi pono i kou mau lima me ke kopa ma mua o ka hoʻomākaukau ʻana i ka meaʻai a ma hope o ka hoʻohana ʻana i ka lua.
• E hoʻomoʻa maikaʻi i ka ʻiʻo, ka iʻa, a me nā hua manu. E hoʻomoʻa i ka ʻiʻo i wili ʻia, ʻoiai a moʻa pono i loko.
• E holoi pono i nā mea kanu maka, nā hua, a me ka letus me ka wai maʻemaʻe.
• E hōʻalo i ka inu ʻana i ka waiū maka/waiū i hoʻomaʻemaʻe ʻole ʻia, nā huahana waiū, a me nā mea inu hua.
• Mai hoʻohana i nā papa ʻokiʻoki, nā pahi, a i ʻole nā ​​mea ʻē aʻe i hoʻohana ʻia no ka ʻiʻo maka a iʻa paha no ka meaʻai i moʻa ʻia. E holoi a hoʻomaʻemaʻe pono iā lākou ma hope o ka hoʻohana ʻana.
• E pale i ka ʻauʻau ʻana i nā loko wai lepo, nā muliwai, a me nā kahawai.
• Inā loaʻa iā ʻoe ka maʻi pākī, e pale i ka hele ʻana i nā loko ʻauʻau.

He maʻi weliweli ʻo HUS. Akā inā ʻike koke ʻia, mālama ʻia a mālama koke ʻia, ʻoi aku ma mua o 85% o ka poʻe e hoʻōla piha . ʻO ka hōʻino ʻana i nā puʻupaʻa he manawa pōkole wale nō. No laila, ʻo ka mea nui loa, ʻo ia ka makaʻala i nā hōʻailona a ʻimi i ke kōkua lapaʻau i ka wā hikiwawe loa.