I fa te hian ni engemaw zat chhung chu riltam a nei tawh em? Nu leh pa zawng zawng hian an ek chhungah thisen tlem an hmuh chuan an hlau ang em? A tam zawkah chuan pum na awlsam tak nia ngaih a ni a, mahse a chang chuan natna khirh zawk chhinchhiahna hmasa ber a ni thei bawk. Chu chu tunlaia kan sawi tum chu a ni, Hemolytic Uremic Syndrome, a tawi zawngin HUS, natna khirh tak, a bik takin E. coli bacteria kai hnuah a lo awm thei a ni. Hemi chungchang hi awlsam tak leh chiang takin i zir ang u.
A awlsam zawngin, HUS chu eng nge ni?
Kan taksa pum puia thisen kalna kawngte hi kawngpui inzawm ang maiin han ngaihtuah teh. Heng kawngte hi kan thisen sen (red blood cells) ten taksa pum puia oxygen an phurh chhuahna hmun a ni. HUS an tih dinhmunah chuan thisen zam (blood clots) a lo awm a, thisen kalna kawng te tak te (capillaries)-ah te, a bik takin kal (kidney)-ah te a inkharkhip a ni . Tui pipe bawlhhlawh leh tuiin a khuh ang mai a ni.
Hetianga thisen kalna kawng a inkhar hian thil pawimawh pathum a thleng thin:
1. Hemolytic Anemia: Thisen kalna kawngkhar (blocked blood cells) kal tlang tum thin thisen sen (red blood cells) te chu an tang a, an tikehsawm a, an chhe bawk. Hei hian taksaa thisen volume a ti tlahniam a, chu chu thisen tlakchhamna (anemia) tihna a ni.
2. Platelet count tlahniam (Thrombocytopenia): Heng thisen zam tura puitu cell te te hi thisen kalna kawng chhunga thisen zam lo awm thinah hian an hmang zo vek a ni. Chumi avang chuan thisena platelet awm zat pangngai chu a tlahniam ta a ni.
3. Kidney Failure: Kidney-in thisen a dawn tawk loh vang leh thisen kalna kawng a chhiat avangin kal hian kan taksa atanga bawlhhlawh a filter tha thei lo va, zun angin a paih chhuak thei lo. Hei hian kal (kidney) a tichhe nghal thei a ni.
Hetiang dinhmun hi kum eng pawhah awm thei mahse naupang kum 5 hnuai lam ah a tam ber a, chuvangin i fain thisen a luak a nih chuan ngaihthah ngai suh.
HUS awm chhan ber chu eng nge ni?
A tam zawkah chuan 90% vel chu HUS hi E. coli (Escherichia coli) an tih bacterium atanga lo chhuak a ni a, chu chuan toxin Shiga toxin tih a siam chhuak thin . He bacteria hi ei tur bawlhhlawh, tui lo emaw tui bawlhhlawh emaw hmangin kan taksaah a lut thin.
He thil thleng hi han mitthla teh. I chhungte nen restaurant-ah chaw i ei dun a. Bawnghnute tui lo (a bik takin bawnghnute hmin), pasteurized loh bawnghnute emaw cheese emaw, emaw lettuce emaw thlai emaw silfai loh i ei chuan E. coli bacteria a awm thei.
He bacteria hi taksaa a luh chuan ni rei lote chhungin pum na a siam a, tui ang maia riltamna a thlen bawk. Ni khat emaw ni hnih emaw chhungin hei hi thisen chhuak riltam a lo ni ta a ni.Bacteria siam chhuah Shiga toxins hian kan intestines wall a tichhia a, thisen a chhuah tir thin. Chumi hnuah chuan heng toxins te hi thisenah lutin taksa pum puiah an fang kual a, kal chhunga thisen kalna kawng te te te chu a tichhia a ni. Hetiang hian HUS hi a intan a ni.
HUS chi hrang hrang lian ber ber a awm em?
Ni e, HUS hi chi hrang hrangah then theih a ni.
- "Typical" HUS: Hei hi tun thlenga kan sawi tawh chi a ni a, a tam ber chu E. coli ang chi bacteria infection vang a ni.
- Atypical HUS (aHUS): Hei hi a rare zawk chi a ni. Genetic defect avanga lo awm a ni. Chumi awmzia chu nu leh pa atanga fate rochun theih a ni tihna a ni. Heng mite hian HUS hi an vei nghal thei a, common cold emaw flu emaw ang chi an nei a nih pawhin.
- Secondary HUS: Hei hi damdawi lam thil dang (e.g. cancer) emaw damdawi thenkhat (e.g. anti-cancer damdawi, immunosuppressants) emaw avanga side effect angin a awm thin.
HUS natna lan chhuah dan chu engte nge ni? Engtin nge a hriat chhuah?
HUS symptoms hi stage hnih ah a lang tlangpui. Pakhatnaah chuan intestinal infection nena inzawm symptoms a lo lang thin. Tichuan, HUS nena inzawm symptom na zawk a lo lang ta a ni.
| Early stage symptoms (infection nena inzawm) . | Late-stage symptoms (HUS nena inzawm) 1.1. |
|---|---|
| Pum natna nasa tak | Paleness (anemia vang) . |
| Luak chhuak leh luak chhuak | Chauhna nasa tak leh mutthilh lohna |
| Tui hmanga ril\am, chutah thisen chhuak ril\am | A hliam awlsam (blue spots) . |
| Khawsik leh khawsik | A tlahniam hle emaw, zun chhuah loh emaw a ni |
| Lu na | Zun chhunga thisen (red/brown color) . |
| Ke, ke ruh leh hmaiah a hring (edema) a awm | |
| Thisen sang lutuk | |
| Seizure emaw, hriatna hloh emaw |
Engtikah nge Doctor i hmuh nghal tur?
Nangmah emaw i fa emaw hian heng symptoms te hi i neih chuan damdawi in Emergency Department (ETU) ah i kal hmasa tur a ni .
- Ni thum aia rei diarrhea.
- Thisen nen riltam.
- I zun chhuah zat a tlahniam nasa hle a nih chuan.
- Naupang chu a sen a, a chau lutuk a nih chuan.
- Taksa a hring a nih chuan.
Engtin nge doctor-te hian HUS status hi an nemnghet?
I enfiahtu doctor chuan i natna lan chhuah dan chu ngun takin a ngaithla ang a, chutah chuan HUS i vei tih finfiah nan test eng emaw zat a ti ang.
- Thisen Test: Hengte hian thisen sen leh platelet count a hniam em tih te, kal hnathawh (creatinine, urea, etc.) te a enfiah thei a ni.
- Urinalysis: Zun chhunga thisen emaw protein emaw a awm leh awm loh enfiah thin.
- Stool Test: Stool-a E. coli O157 ang chi bacteria awm leh awm loh a enfiah thin.
- Kidney Biopsy: A châng chuan, a natna hriat chian nân kal a tê tê tak tak lak a ngai thei a, test a ngai thei bawk.
HUS enkawlna tur engte nge ni?
HUS hi damdawi ina dah ngai a ni . In lama enkawl theih a ni lo. Hengte hi damdawi inah enkawl dan tlangpui an ni.
1. Saline leh nutrition pe: Luak leh luak hian taksa atanga tui leh chi (salts) te paih chhuakin dehydration a thlen thei. Chumi ven nan chuan vein hmangin saline (IV fluids) pek thin a ni. I ei theih loh chuan tube hmangin nutrition pek a ni.
2. Thisen leh platelet pek dan: 1.1.Thisen hi red blood cell count a tlem lutuk (anemia) a nih chuan thisen pek thin a ni. Platelet count a tlem lutuk a, thisen chhuah theihna a awm chuan platelet pek thin a ni bawk.
3. Dialysis: Kal a chak lo lutuk a, taksa atanga bawlhhlawh paih chhuak thei lo a nih chuan thisen tifai thei khawl, dialysis tih a ngai a ni. Hei hi hun eng emaw chen atana tih tur a ni fo thin. Dialysis hi kal (kidney) hnathawh tan leh chuan tihtawp theih a ni.
4. Damdawi bik: Damdawi chi tlemte atypical HUS (aHUS) ang chi tan chuan damdawi bik eculizumab emaw ravulizumab emaw hman thin a ni.
Pawimawh tak chu zirchianna thenkhatah chuan E. coli natna avanga ril\amna atana antibiotics emaw antidiarrheal damdawi emaw pek hian HUS vei theihna a tipung thei tih an hmuchhuak. Chuvang chuan Doctor rawn hmasa lovin mahni indam ngai suh.
HUS pumpelh nan eng nge kan tih ang?
HUS laka invenna tha ber chu kan nitin nunah thil tenawm tak tak te hi kan enkawl hi a ni.
- Chaw i buatsaih hma leh toilet i hman zawhah sahbawn hmangin i kut uluk takin silfai thin ang che.
- Sa, sangha leh artui te chu uluk takin chhum rawh. Sa hmin, a bik takin sa hmin chu a chhunga a lum that thlengin chhum rawh.
- Thlai raw, thei leh lettuce te chu tui thianghlim hmangin uluk takin silfai thin ang che.
- Unpasteurized/raw milk, dairy products, leh thei in tur te in loh tur.
- Cutting board, chemte, sa raw atana hman tur thil dang emaw, sangha emaw ei tur siam nan hmang suh. Hman zawhah uluk takin silfai la, tifai bawk ang che.
- Tuikhuah bawlhhlawh, lui leh luiah te tui chawi loh tur.
- Diarrhea i neih chuan swimming pool-a kal loh tur a ni.
HUS hi dinhmun hlauhawm tak a ni. Mahse a hmaa hmuhchhuah a nih a, enkawl leh enkawl vat a nih chuan mi 85% aia tam chu an dam vek . Kal chhiatna hi rei lo te chhung chauh a ni fo. Chuvangin a pawimawh ber chu a natna lan chhuah dan hriat chian a, a rang thei ang bera damdawi lam thurawn lak hi a ni.
Take-Home Thuchah a ni
- Hemolytic Uremic Syndrome (HUS) hi natna khirh tak a ni a, kal (kidney) a nghawng ber a ni.
- Hetiang dinhmun hi E. coli an tih bacteria avanga ril\am hnuah a lo awm fo \hin.
- Thisen chhuak riltam, a hring lutuk, zun chhuah tlem, leh a hringHUS vaukhânna chhinchhiahna lian ber berte chu:
- Heng symptoms te hi a lo awm chuan naupang emaw damlo emaw chu tihkhawtlai lovin damdawi inah hruai nghal tur a ni.
- Damdawi ina a hun taka enkawl a nih chuan mi tam tak chu an dam kim vek a ni.
- Ei leh in leh mimal faina enkawl hian HUS thlentu E. coli infection a veng thei a ni.
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