Ke ulu koke nei nā kiko poni o kāu keiki liʻiliʻi ma ko lākou kino? He Henoch-Schönlein Purpura (HSP) paha ia! E kamaʻilio kākou e pili ana i kēia?

He mea maʻamau ke hopohopo iki inā ʻike koke kāu keiki i nā kiko poni liʻiliʻi ma ko lākou kino, ʻoi aku hoʻi ma ko lākou mau wāwae a me nā puʻupuʻu, ma hope o ka pāʻani hauʻoli. I kekahi manawa hiki ke hele pū kēia mau kiko me ka ʻeha o ka ʻōpū a me ka ʻeha o nā hono. Ke ʻike mākou i kahi mea e like me kēia, noʻonoʻo mākou i hoʻokahi mea ma hope o kekahi. No laila i kēia lā e kamaʻilio mākou e pili ana i kahi maʻi e hiki ai ke hoʻoulu i kēia mau hōʻailona, ​​​​akā ʻo ka hapa nui o ka manawa ʻaʻohe mea e hopohopo ai, akā he mea nui loa ia e makaʻala. ʻO ia ʻo Henoch-Schonlein Purpura, a i ʻole HSP no ka pōkole.

He aha ka Henoch-Schönlein Purpura (HSP)?

I ka ʻōlelo maʻalahi, ʻo Henoch-Schonlein Purpura (HSP) kahi kūlana kahi e pehu ai a mumū paha nā kīʻaha koko liʻiliʻi i loko o ko mākou kino. Ua kapa nā kauka i kēia " vasculitis ." E noʻonoʻo e like me nā kīʻaha koko liʻiliʻi ma loko o ko mākou kino e huhū a pehu ana. ʻO kēia pehu ke kumu o kēia mau pilikia āpau.

Ke pehu nā kīʻaha koko ma kēia ʻano, hoʻomaka nā hunaola koko liʻiliʻi e kahe i waho. E like me ka paipu wai e kahe ana i ka wai. Hiki i kēia mau hunaola koko ke kahe i loko o ka ʻili, nā membrane mucous (e like me nā membrane pulu i loko o ko kākou waha a me ko kākou ihu), a i ʻole i loko o nā ʻōpū o loko. Ke kahe lākou i loko o ka ʻili, hana lākou i kēlā mau kiko poni, e like me ka palapū. Kāhea mākou i kēlā mau kiko he `(purpura)`.

ʻO ka hapa pinepine, hoʻopilikia kēia maʻi HSP i nā kīʻaha koko i loko o ka ʻili, nā hono, nā ʻōpū (nā ʻōpū), a me nā puʻupaʻa. Akā ʻo ka nūhou maikaʻi, ʻo ka hapa nui o nā keiki i loaʻa iā HSP e hoʻōla piha i loko o kekahi mau pule me ka ʻole o nā pilikia lōʻihi . No laila he mea nui e ʻike i ka ʻoiaʻiʻo ma mua o kou hopohopo.

He aha nā kumu o ka HSP?

ʻAʻole hiki i nā kauka ke ʻōlelo maopopo i ke kumu o ka HSP. Akā manaʻo lākou e hoʻomaka paha ia ma hope o kahi maʻi . Hiki ke lilo i maʻi bacteria, viral, a parasitic paha. No ka laʻana, hiki i kekahi mau keiki ke loaʻa i ke kūlana ma hope o ka ʻeha ʻana o ka puʻu.

Ma waho aʻe o kēlā, ua manaʻo ʻia hiki ke hana ʻia e kekahi mau lāʻau lapaʻau a me nā maʻi ʻaʻai. Loaʻa paha i kekahi poʻe kahi predisposition genetic. Ke ʻimi nei nā kānaka noiʻi i ke kumu pololei o HSP.

Hiki mai ka HSP ke hana pono ʻole kā mākou ʻōnaehana pale. Loaʻa iā mākou kahi ʻano protein kūikawā i kapa ʻia ʻo `(Immunoglobulin A - IgA)` i loko o ko mākou kino. ʻO kāna hana nui ke kaua aku i nā maʻi a pale iā mākou mai nā maʻi. Akā ʻo ka mea e hana ʻia i loko o ke kino o ke kanaka me HSP, ʻo ia ka waiho ʻana o kēia protein `(IgA)` i loko o kēlā mau kīʻaha koko liʻiliʻi. ʻO ia ka manawa e hana ʻia ai kēlā ʻano `(vasculitis)`, ka mea e hoʻoulu ai i nā kīʻaha koko e pehu.

ʻO HSP ke ʻano maʻamau o ka vasculitis i nā keiki . ʻOiai hiki ke loaʻa i kēlā me kēia makahiki, ʻoi aku ka maʻamau i nā keiki ma waena o 2 a me 6 mau makahiki. ʻOi aku ka pālua o ka maʻamau i nā keikikāne ma mua o nā kaikamahine. Loaʻa pinepine hoʻi ia i ka hāʻule a me ka hoʻoilo (ʻo ia hoʻi, ma ka hopena o ka makahiki).

He aha nā hōʻailona o ka HSP?

I kēia manawa, e nānā kākou i nā hōʻailona e hōʻike ai i kahi keiki inā loaʻa iā lākou ka HSP.

Nā kiko ʻili `(Purpura)`

ʻO kēia ka hōʻailona nui a maopopo loa o HSP . ʻIke ʻia nā wahi liʻiliʻi, poni e like me nā palapū ma ka ʻili. ʻAʻole e mae kēia mau wahi ke nānā aku ʻoe iā lākou (he ʻulaʻula ʻaʻole e pala).

• ʻIke pinepine ʻia kēia mau kiko ma nā wāwae haʻahaʻa a me nā puʻupuʻu .
• I kekahi manawa hiki ke ʻike ʻia kēia mau kiko ma nā lima, ka maka, a me nā ʻāpana waena o ke kino, e like me ka umauma a me ka ʻōpū.
• Hiki ke ʻike koke ʻia kēia mau kiko, a i ʻole e hoʻonui mālie ʻia paha.

ʻEha a me ka pehu ʻana o nā hono

No nā keiki he nui, hiki ke ʻeha a me ka pehu ʻana o nā hono ma kahi o hoʻokahi a ʻelua paha pule ma mua o ka puka ʻana o ka ʻulaʻula ʻili .

• Hoʻopilikia pinepine ia i nā hono o nā kuli a me nā kuʻekuʻe wāwae .
• I kekahi manawa hiki ke hoʻopilikia ʻia nā hono e like me ke kuʻekuʻe lima a me ka pulima .
• Hiki i kēia ʻeha ke paʻakikī i ke keiki ke hele.

ʻeha ka ʻōpū

Hoʻomaka pinepine ka ʻeha o ka ʻōpū ma hope o ka puka ʻana o nā ʻulaʻula ʻili.

• Hiki paha iā ʻoe ke ʻike i nā ʻeha o ka ʻōpū.
• Ka luaʻi a me ka luaʻi .
• Hiki i kekahi mau keiki ke loaʻa ke koko i loko o ko lākou mau ʻōpala (ke koko i loko o nā BM/ʻōpala). He hōʻailona kēia e hopohopo ai.

Nā hopena ma nā puʻupaʻa

I kekahi mau hihia, hiki i ka HSP ke hoʻopili i nā puʻupaʻa .

• Hiki ke hoʻoheheʻe ʻia kahi koko liʻiliʻi a i ʻole ka protein me ka mimi .
• I kekahi manawa ʻike ʻia ka ʻulaʻula o ka mimi (hematuria).
• ʻOiai ʻaʻole kēia he mea koʻikoʻi i ka hapa nui o nā hihia, he mea nui loa ia e ʻike i ke kauka e nānā inā he hopena ma nā puʻupaʻa.

ʻO ka maʻamau, e mau ana nā hōʻailona o ka HSP ma kahi o hoʻokahi mahina , a ma hope o ia mea e hoʻōla hou ka hapa nui o nā keiki iā lākou iho.

Pehea e ʻike pololei ai nā kauka i ka HSP?

Ke lawe ʻoe i kāu keiki i ke kauka, ʻo ka mea mua a lākou e hana ai, ʻo ia ke nānā pono i ke keiki. ʻOiai aia kēlā mau kiko purpura i loko o ka hapa nui o nā maʻi HSP, he kōkua nui lākou no nā kauka i ka ʻike ʻana i ka maʻi.

Eia kekahi, hiki i ke kauka ke hana i nā hoʻokolohua e like me:

• Nā hoʻāʻo koko: Hiki ke hoʻohana ʻia kēia mau mea e nānā i ka hana o nā puʻupaʻa, e nānā i nā maʻi, a e nānā i nā pilikia o ke kāpili ʻana o ke koko.
• Hoʻāʻo mimi: E nānā i ke koko a i ʻole ka protein i loko o ka mimi. Hiki i kēia ke hāʻawi i kahi manaʻo inā ua hoʻopilikia ʻia nā puʻupaʻa.
• Hoʻāʻo ʻana i ka noho: E nānā inā he koko i loko o ka noho.
• ʻO ke scan Ultrasound: Inā loaʻa i kāu keiki ka ʻeha nui o ka ʻōpū, hiki i kēia ke kōkua i ka hoʻoponopono ʻana i nā pilikia ʻē aʻe i loko o ka ʻōpū, ʻoiai ke ʻano i kapa ʻia ʻo intussusception.

Ma hope o ka hana ʻana i kēia mau hoʻokolohua a pau, hoʻoholo ke kauka inā he HSP kou a me kona koʻikoʻi.

He aha nā lāʻau lapaʻau no HSP?

ʻO ka hapa nui o ka manawa, hoʻopau wale ʻo HSP me ka ʻole o kekahi lāʻau lapaʻau kikoʻī . ʻO ia ka nūhou maikaʻi. Eia nō naʻe, inā ua hoʻopilikia ka HSP i kou mau puʻupaʻa, a laila pono paha ka lāʻau lapaʻau.

I mea e kōkua ai i kāu keiki e ʻoluʻolu a kāohi i nā hōʻailona, ​​​​hiki i kāu kauka ke ʻōlelo i nā lāʻau lapaʻau e like me:

• Nā lāʻau antibiotic: Hāʻawi wale ʻia kēia mau mea inā manaʻo ʻia ua hana ʻia ka HSP e kahi maʻi bacteria.
• Nā lāʻau hōʻoluʻolu ʻeha: No ka laʻana, hiki i ka acetaminophen (e like me ka paracetamol) ke kōkua i ka hōʻemi ʻana i ka ʻeha o nā hono a me nā ʻeha kino.
• Nā lāʻau lapaʻau anti-inflammatory: No ka laʻana, hiki i nā lāʻau lapaʻau e like me ka ibuprofen ke kōkua i ka hōʻemi ʻana i ka ʻeha a me ka pehu ʻana i nā hono.
• ʻO nā Corticosteroids: No ka laʻana, nā lāʻau lapaʻau e like me ka prednisone. Hāʻawi wale ʻia kēia mau mea inā loaʻa i ke keiki ka ʻeha nui o ka ʻōpū a i ʻole ka maʻi puʻupaʻa. Pono e hoʻohana ʻia kēia mau mea ma lalo o ka nānā ʻana a ke kauka.

Nā mea hiki iā ʻoe ke hana ma ka home

Ma waho aʻe o ka lāʻau lapaʻau, aia kekahi mau mea hiki iā ʻoe ke hana ma ka home e hōʻoluʻolu ai i kāu pēpē:

• E hoʻomaha maikaʻi i kāu keiki: E hōʻemi i ka nui o ka holo ʻana a me ka pāʻani ʻana a puni, a paipai iā lākou e noho ma kahi moe a heluhelu i kahi puke.
• E hāʻawi i ka nui o nā wai e inu ai:ʻO ka hāʻawi ʻana i nā mea e like me ka wai a me ka wai huaʻai e kōkua i ka pale ʻana i ka maloʻo ʻana.
• Inā pehu a ʻeha kou mau hono: Hiki iā ʻoe ke hoʻokiʻekiʻe iā lākou no kekahi manawa, a malia paha e kau i kahi ʻeke hau ma luna o lākou inā haʻi aku kāu kauka iā ʻoe.

ʻO ka mea nui loa, ʻo ia ke lawe koke i kāu keiki i ke kauka inā hōʻole lākou e ʻai a inu paha, inā loaʻa iā lākou ka ʻeha nui o ka ʻōpū, a inā hōʻike lākou i nā hōʻailona o nā pilikia o nā puʻupaʻa (e laʻa, ka emi ʻana o ka mimi, ka pehu ʻana). Pono paha lākou e lawe ʻia i ka haukapila no ka mālama ʻana.

Aia kekahi mau pilikia ʻē aʻe e hiki ke hana ma muli o ka HSP?

Ma kahi o ka hapalua o nā keiki me HSP e loaʻa paha kekahi hopena i ko lākou mau puʻupaʻa. I ka hapanui o nā hihia, he hopena liʻiliʻi wale nō kēia a hoʻopau ʻia me ka ʻole o kekahi lāʻau kūikawā. Eia naʻe, he mea kākaʻikahi loa, hiki i kekahi mau keiki ke loaʻa i nā kūlana koʻikoʻi e like me ka hāʻule ʻana o ka puʻupaʻa. Pono paha kēlā mau keiki e ʻike i kahi loea puʻupaʻa (nephrologist) no ka hoʻāʻo hou aku.

ʻO kekahi maʻi lapaʻau kakaʻikahi akā koʻikoʻi loa, ʻo ia ka intussusception. ʻO kēia ka wā e nānā ai kekahi ʻāpana o ka ʻōpū i loko o kekahi ʻāpana . Hiki i kēia ke ʻoki i ke kahe koko i kēlā ʻāpana a hana i kahi paʻa. He pilikia kēia e pono e mālama koke ʻia. Inā loaʻa koke i kāu keiki ka ʻeha ʻōpū koʻikoʻi a pinepine, e luaʻi ana, a i ʻole he koko e like me ka jelly i loko o ko lākou ʻōpala, pono ʻoe e kānalua i kēia.

Nā mea nui ʻē aʻe e pono ai mākou e ʻike

• ʻO ka mea maikaʻi loa, ʻo ka hapa nui o nā keiki i loaʻa i ka HSP e hoʻōla piha i loko o hoʻokahi mahina a ʻaʻole e loaʻa i nā pilikia lōʻihi.
• Hiki i kekahi mau keiki ke loaʻa hou i ka HSP. Hana pinepine kēia i kekahi mau mahina ma hope o ka hanana mua. Eia nō naʻe, inā hana hou ia, ʻaʻole ia e ʻoi aku ka koʻikoʻi ma mua o ka hanana mua .

No laila, he aha ka leka lawe home mai kēia mau mea a pau?

ʻAe, no laila, mai nā mea a mākou i kamaʻilio ai, eia nā mea nui e hoʻomanaʻo:

• He kūlana ka HSP e hiki ke hoʻopilikia i nā keiki ʻōpio, e hoʻoulu ai i nā kīʻaha koko pehu. ʻO ka hōʻailona nui he mau kiko poni.
• I ka hapanui o ka manawa, e ho'ōla ʻia kēia ma kāna iho.
• Hiki ke hōʻeha ʻia nā hono, ka ʻeha o ka ʻōpū, a me ka hōʻino ʻia ʻana o nā puʻupaʻa.
• Inā ʻike ʻoe i nā kiko ʻē ma ke kino o kāu keiki, inā ʻōhumu lākou i ka ʻeha o ka ʻōpū, a inā ʻeha ko lākou mau hono, e lawe pono iā lākou i ke kauka. Mai hopohopo, akā e ʻimi koke i ke kōkua lapaʻau.
• E hahai pono i nā ʻōlelo a ke kauka. E hāʻawi i kāu keiki i ka nui o ka hoʻomaha a me nā wai he nui.
• Hoʻōla piha ka hapa nui o nā keiki. E makaʻala i nā pilikia kakaikahi.

E hoʻomanaʻo, ʻaʻole ʻoe hoʻokahi. Aia nā kauka ma laila e kōkua iā ʻoe a me kāu pēpē. ʻO ka ʻike ʻana i kēia ʻano ʻike e hāʻawi iā ʻoe i ka ikaika nui e hana i ka manawa kūpono.

No laila, ke lana nei koʻu manaʻo he mea kōkua kēia ʻike iā ʻoe. Makemake au i kāu keiki e ho'ōla koke!

ʻO ka purpura Henoch-Schonlein, HSP, nā maʻi o nā keiki, nā kiko ʻili, vasculitis, IgA vasculitis, nā maʻi pediatric