Nu emaw, pa emaw chuan an fate taksaa thil mak tak tak an hmuh hian an hlauhthawn leh lungkhamna chu ka hrethiam. A bik takin naute piang tharin an vunah blue-purple spot a neih thut chuan a buaithlak hle thei. Hetiang dinhmun hi damdawi lam chuan "Blueberry Muffin Rash" kan tih hi a ni. He hming hi thil mak tak angin a lang thei a, mahse a hnungah hian chhan lian tham engemaw zat a awm theih avangin hriat a pawimawh hle.
He ‘blueberry muffin rash’ hi eng nge ni?
A awlsam zawngin sawi ila, hei hi vun natna a ni a, nausen piang thar leh nausen te pawh a nghawng thei a ni. ‘blueberry muffin rash’ an ti a, a chhan chu a spot te hi blueberry muffin-a blue-purple dots ang deuh a nih vang a ni. Anni hi circular patch angin emaw, vunah raised nodules angin emaw an lang thei.
A pawimawh ber chu heng hmul te hi vun chung lamah a awm lo va, vun chhung thuk takah a lo awm niin a lang . Hei hi rash pangngai a ni lo.
Heng spot te hi a lo lang thei chhan lian tak pathum a awm a, chungte chu:
1. Extramedullary hematopoiesis: A tlangpuiin kan thisen hi ruhro (bone marrow) ah a lo chhuak thin . Mahse, damdawi lam dinhmun thenkhat avang hian thisen siamtu cell te chu an pungkhawm tan a, ruhro pawnah, vunah ang chiah hian cluster an siam tan thin. Heng cell cluster te hi spot anga lang te hi an ni.
2. Vun chhunga thisen chhuak (Purpura): Hetiang purple spot hi thisen kalna kawng a chhiat avanga vun tissue-a thisen a luang lut emaw, thisen zam chak lohna emaw avanga lo awm thei a ni.
3. Cancer cells darh (Metastasis): Cancer chi thenkhatah chuan cancer cell hi taksa peng dang atanga vunah a darh thei a, hetiang hian lumps a siam thei bawk.
Heng pathumte thlentu damdawi lam dinhmun hnuaia awm tam zawk hi chu a tlem hle. Tin, i naute hian heng spot te nen hian symptom dang a nei fo bawk ang. Heng spot te hi a mah chauhin a dam dawn lo. Chuvangin, ‘blueberry muffin rash’ hi i naute hian damdawi lam pan vat a ngai tih chhinchhiahna nghet tak a ni.
Hetiang thil thlen theitu berte chu engte nge ni?
Ngaihtuah buai suh, hei hi a nghawng chhan chi hrang hrang chiang takin kan sawi dawn a, pakhat hnu pakhatin.
TORCH Hri kai te
TORCH hi natna chi hrang hrang, nausen emaw, nausen pum chhunga nau piang thar emaw a nghawng theihna acronym a ni. Heng natnate hi naupai lai te, nau neih lai te, nau piang hnua nu atanga naute hnena kai theih a ni.
TORCH tih awmzia chu:
- T - Toxoplasmosis natna (Toxoplasmosis) natna a ni
- O - Hri kai dang - entirnan syphilis, chickenpox, parvovirus B19
- R. A rilru a hah lutuk- Rubella a ni
- C - Cytomegalovirus (CMV) natna hrik pai a ni.
- H - Herpes simplex virus (HSV) natna hrik hrik pai a ni.
Heng natna hrik te nen hian naute hian natna dang a lantir thei bawk a, chungte chu khawsik, chaw ei harsa, jaundice, nau piang rit lo, hriatna lama harsatna, leh thin leh ril (hepatosplenomegaly) te a ni.
Hei hian a hun taka doctor pan a, naupai laiin a tul anga test neih a pawimawh zia a tilang chiang hle. Hei hmang hian heng natna chi hrang hrang i neih leh neih loh emaw, immunity i neih leh neih loh emaw i hre hmasa thei ang.
Tumor leh Cancer thenkhat
Naupang cancer chi thenkhat pawh hian he ‘blueberry muffin rash’ hi a thlen thei bawk. Hengte hi dinhmun a tlem hle.
- Histiocytosis tih a ni
- Leukemia (thisen cancer) 1.1.
- Mastocytosis natna (Mastocytosis) a ni
- Neuroblastoma natna a ni
- Rhabdomyosarcoma natna a ni
- Transient myeloproliferative disorder - Hei hi Down syndrome nei naupangte zingah a tam hle.
Heng dinhmunte hi hah lutuk, khawsik, taksa rihna tlahniam, vun rawng (anemia vang), lymph node hring, leh thawk harsatna te nen a inzawm thei a ni.
Thisen siam chhuahna nena inzawm harsatna dangte (Extramedullary Hematopoiesis) .
Kan sawi tawh ang khan heng spot te hi extramedullary hematopoiesis vang pawh a ni. Chutianga titu thil dang ṭhenkhat chu:
- Nausen piang thar Hemolytic disease: Naute thisen sen (red blood cells) te chu nu leh naute inkara ABO thisen chi hrang hrang inrem lohna ang chi thil vangin a chhe chak hle.
- Hereditary spherocytosis: Thisen sen (red blood cells) pianzia tidanglam thei, thlahtute atanga lo chhuak a ni.
- Twin-to-twin transfusion syndrome: Nausen pakhat, nausen piang ve ve, nausen pahnih inkara thisen kal dan inang lo.
Engtin nge doctor-te hian a chhan dik tak chu an zawn chhuah?
I naute doctor chuan uluk takin a enfiah hmasa ang a, symptom dang a awm leh awm loh a enfiah hmasa ang. Tichuan, a chhan dik tak hriat tumin test engemaw zat neih an rawt ang.
| Fiahna | Eng nge a Check? |
|---|---|
| Thisen test a ni | Thisen chhiar kim (CBC), natna hrik leh thisen lama thil danglam dang test te. |
| Urinalysis tih a ni | Infection thenkhat chhinchhiahna leh damdawi lam dinhmun. |
| Spinal tap/Lumbar Puncture hmanga tihdam theih a ni | Cerebrospinal fluid (CSF) enfiah la, natna hrik awm leh awm loh enfiah rawh. |
| Vun biopsy tih a ni | Leukemia emaw cancer cell dang emaw enfiah nan. |
| Bone marrow biopsy neih a ni | Leukemia, thisen dik lo dang, hri kai, leh cancer zawng zawng. |
| Pum chhunga ultrasound hmanga tih a ni | Liver leh spleen lian leh neuroblastoma ang chi tumor awm leh awm loh enfiah. |
TORCH infection nia rinhlelh a nih chuan doctor chuan nu tan pawh a kaihhnawih test neih a rawt thei bawk.
Hei hi eng enkawlna nge ni?
Hei hi mi tam takin harsatna an neih a ni. ‘Blueberry muffin rash’ enkawlna chu a chhan bulpui (underlying condition) enkawl hi a ni tih hre reng ang che. Chu chu, heng spot te hi symptom a nih avangin symptom thlentu underlying condition chu kan enkawl a ngai tihna a ni.
Entir nan:
- A chhan chu TORCH infection a nih chuan antibiotics, antiparasitics, antiviral damdawi te pek thin a ni.
- A chhan chu cancer ang chi neuroblastoma a nih chuan surgery, chemotherapy, immunotherapy, emaw radiation therapy emaw a ngai mai thei.
I naute medical team chuan i naute enkawlna tur ruahmanna tha ber an hrilhfiah ang a, chuvangin zawhna emaw, i ngaihtuahna emaw i neih chuan sawipui hreh suh.
Engtikah nge Doctor i hmuh nghal tur?
Chumi chhanna awm chhun chu "Immediate!"
I naute taksaah hian blue-purple spot emaw hetiang lump emaw i hmuh chuan ngaihthah suh. I naute chu damdawi inah enkawl mek a nih chuan doctor emaw nurse emaw hnenah hriattir nghal rawh. In lama i awm chuan i naute chu damdawi in hnai ber Emergency Treatment Unit (ETU)-ah hruai nghal rawh.
Hetiang dinhmun hi a tlem hle nachungin, i naute taksaah thil pawi tak a thleng tih hriattirna a ni thei. Hei hi a hlauhawm hle thei a, mahse a pawimawh ber chu hlauthawng lo leh hmalak vat hi a ni. Medical team chuan a chhan chu rang takin an hmu ang a, i naute tan enkawlna tha ber an pe ang.
Take-Home Thuchah a ni
- Blueberry Muffin Rash hi vun natna mai a ni lo va, a hnuaia natna khirh tak chhinchhiahna a ni thei bawk.
- A bik takin heng spot te hi vun chhungah ni lovin vun chhungah a lo awm niin a lang.
- I naute vunah heng chi hrang hrang i hmuh chuan tihkhawtlai suh la, doctor hnenah entir nghal emaw, damdawi in Emergency Treatment Unit (ETU)-ah emaw kal nghal rawh.
- Naupai lai hian damdawi lam thurawn leh test mumal tak lak a pawimawh a, TORCH ang chi natna hrik laka inven emaw, hriat hmasak emaw a pawimawh hle.
- I diagnosis leh treatment plan chungchangah i medical team te nen zalen takin sawiho rawh. Nang leh i naute mamawh puihna an pe ang.
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