Ngaba umzimba wakho uyazitshabalalisa iiseli zakho ezibomvu zegazi? Nantsi into ekufuneka uyazi malunga ne-Autoimmune Hemolytic Anemia (AIHA)!

Ngaba ngamanye amaxesha uziva udiniwe kwaye udiniwe ngaphandle kwesizathu? Mhlawumbi ulusu lwakho lujike lwaba mhlophe okanye lube tyheli. Kukho amaxesha apho ungasiqondi isizathu sokuba oku kwenzeke, akunjalo? Esinye sezizathu zezi mpawu sinokuba yinkqubo yomzimba wakho yokuzikhusela, amajoni akukhusela kwizifo, ahlasela iiseli zakho ezibomvu zegazi. Yiloo nto siyibiza ngokuba yi-'Autoimmune Hemolytic Anemia' (AIHA) kwezonyango. Ngamafutshane, inkqubo yokuzikhusela yomzimba wakho iphosisa iiseli zakho ezibomvu zegazi "njengotshaba" kwaye izitshabalalise. Nangona oku kunzulu kancinci, kunokulawulwa kakuhle ngonyango olufanelekileyo . Nangona kunjalo, ukuba akunyangwa, kunokuba yingozi ebomini. Ke ngoko, kubaluleke kakhulu ukuqaphela oku kwaye ufune iingcebiso zonyango ngokukhawuleza. Masithethe ngale nto ngokweenkcukacha.

Yintoni i-'Autoimmune Hemolytic Anemia' (AIHA)?

Ngamafutshane, i-`Autoimmune Hemolytic Anemia` (AIHA) yimeko apho inkqubo yakho yomzimba iyazichaza ngempazamo iiseli zakho ezibomvu zegazi "njengezasemzini," oko kuthetha into eyingozi emzimbeni. Ngenxa yoko, umzimba wakho uvelisa ii-antibodies ezitshabalalisa iiseli ezibomvu zegazi. Ezi antibodies zinamathela kwiiseli ezibomvu zize zizitshabalalise. Kwenzeka ntoni ke ngoko? Inani leeseli ezibomvu zegazi emzimbeni wakho liyancipha. Yiloo nto siyibiza ngokuba yi-"anemia."

Khawucinge nje, okwenzekayo apha kufana nomkhosi okhusela ilizwe lethu, uhlasela ngempazamo abemi bethu. Oku kunzima kancinci, kodwa akunzima ukukuqonda.

Yintoni umahluko phakathi kwe-AIHA yesikolo samabanga aphantsi nesesibini?

Kukho iintlobo ezimbini eziphambili ze-AIHA kuxhomekeke kwindlela eyenzeka ngayo.

• I-AIHA ePhambili: Ngamanye amaxesha, i-AIHA inokukhula ngaphandle kwengxaki yempilo ecacileyo. Oku kuthetha ukuba oogqirha abakwazi ukuqonda ukuba kutheni ivele ngequbuliso. Oku kubizwa ngokuba yi-AIHA ePhambili.
• I-AIHA yesibini: Olunye uhlobo lwe-AIHA kuxa i-AIHA ibangelwa yenye imeko. Umzekelo, inokubangelwa zizifo ezithile zentsholongwane, izifo ezizikhuselayo emzimbeni (apho amajoni omzimba ahlasela khona izicubu zawo), amayeza athile, okanye umhlaza wegazi ongaphantsi ofana ne-lymphoma.

Ziziphi iintlobo eziphambili ze-AIHA?

Kukho iintlobo ezimbini eziphambili ze-AIHA. Ezi ntlobo zezi ``Warm autoimmune hemolytic anemia`` kunye ``Cold autoimmune hemolytic anemia`` . Ezi zahlulwe ngokweentlobo zee-antibodies ezibandakanyekayo kwesi sifo. Oko kukuthi, igama livela kubushushu apho ii-antibodies ezihlasela iiseli ezibomvu zegazi zisebenza khona.

I-anemia ye-hemolytic ye-autoimmune efudumeleyo

Olu lolona hlobo luqhelekileyo lwe-AIHA. Apha, ii-antibodies zohlobo lwe-`IgG` zibopha kwiiseli ezibomvu zegazi. Into ekhethekileyo kukuba ezi antibodies zisebenza kubushushu obuqhelekileyo bomzimba wethu (oko kukuthi, kwindawo "efudumeleyo"). Iimpawu zihlala ziqala ukubonakala kancinci kancinci, kwiiveki ezimbalwa. Nangona kunjalo, kwezinye iimeko, iimpawu zinokuba nzima nakwiintsuku ezimbalwa.

I-anemia ye-hemolytic ye-autoimmune ebandayo

Olu hlobo lubonwa kuphela kwi-10% ukuya kwi-20% yezigulana ze-AIHA. Lubandakanya uhlobo lwe-autoantibodies olubizwa ngokuba yi-'IgM'. Ezi autoantibodies zibopha kwiiseli ezibomvu zegazi xa igazi lakho likwiqondo lobushushu eliphantsi kunobushushu bomzimba wakho, obubizwa ngokuba yi-'cold''. Eli qondo lobushushu 'elibandayo'' linokwahluka kumntu nomntu. Oku kuthetha ukuba kwabanye abantu, ezi antibodies zingasetyenziswa xa zibanda kancinci, ngelixa kwabanye, zinokufuna ukuba zibanda kakhulu.

Ngubani ochaphazeleka kakhulu yile meko ye-AIHA?

I-AIHA inokukhula nakubani na, nokuba uneminyaka okanye isini. Nangona kunjalo, le meko ixhaphake kakhulu kubafazi abangaphezu kweminyaka engama-40 ubudala .

Nangona ixhaphake kangaka, i-AIHA yimeko engaqhelekanga . Ichaphazela malunga nomntu omnye okanye ababini kwikhulu lamawaka ngonyaka.

Zithini iimpawu ze-AIHA?

I-AIHA inokubangela iimpawu ezahlukeneyo. Ezinye zixhaphakile, ngelixa ezinye zahluka ngokuxhomekeke kuhlobo lwe-AIHA onayo.

Nazi ezinye zeempawu eziqhelekileyo:

• Ifiva
• Ukudinwa kakhulu (ukudinwa kakhulu ukuba ungenza nantoni na kakuhle)
• Ubuthathaka
• Ukubetha kwentliziyo
• Ubunzima bokuphefumla (nokuba kusetyenziswe kancinci)
• Ulusu oluphaphathekileyo (njengaxa unegazi eliphantsi)
• I-Jaundice (ukutyheli kolusu namehlo)
• Intloko ebuhlungu (intloko ebuhlungu)
• Intlungu yemisipha
• Umchamo omnyama (njengamanzi eti)
• Ukuhlanza kunye nesicaphucaphu
• Ukuqhawukelwa ngumphefumlo
• Urhudo
• Ukulimala kolwimi
• Ukubetha kwentliziyo (ukuziva intliziyo yakho ibetha kangangokuba ungayiva)

Khumbula, ukuba nenye okanye ezimbini kwezi mpawu akuthethi ukuba une-AIHA. Kodwa ukuba ezi mpawu ziyaqhubeka, kungcono ukubona ugqirha.

Iimpawu zingahluka, ingakumbi kuxhomekeke kuhlobo lwe-AIHA:

I-AIHA efudumeleyo ixhaphake kakhulu kwi:

• Ukudinwa
• Isiyezi
• I-Jaundice (ukutyheli kolusu)
• Ukuva ukubetha kwentliziyo

I-AIHA ebandayo ingabangela iimpawu ezifana nezi:

• Ukudinwa
• Isiyezi
• Izandla neenyawo ezibandayo (ukuziva ubanda ngaphezu kwabanye)
• I-Jaundice
• Iintlungu zesifuba
• Intlungu ngasemva kwemilenze
• Isifo sikaRaynaud (imeko apho iminwe neenzwane zijika zibe mhlophe/ziluhlaza okwesibhakabhaka kwaye zingabi nangqondo xa zibekwe emakhazeni)
• Ukutshintsha kombala wezandla neenyawo okwesibhakabhaka
• Ukuphazamiseka kwentliziyo `(Arrhythmia)`
• Ukuva intliziyo ikhala
• Ukusilela kwentliziyo (oku kwenzeka kwiimeko ezinzima)

Zithini izizathu ze-AIHA?

Kwisiqingatha sabo bonke abaguli abane-AIHA (malunga nama-50%), unobangela ochanekileyo awufumaneki . Oku sikubiza ngokuba yi-"idiopathic autoimmune hemolytic anemia." Oko kuthetha ukuba "akukho sizathu saziwayo."

Kwelinye icala, i-AIHA inxulunyaniswa nezinye iimeko zonyango.

Ezinye iimeko zonyango ezinokubangela i-AIHA ziquka:

Kukho izifo ezininzi ezibangelwa kukuzikhusela komzimba ezinokubangela i-AIHA yesibini. Oko kukuthi, ezinye izifo apho amajoni omzimba ahlasela iiseli zomzimba ezisempilweni.

• I-Lupus : Esi sisifo esinokuchaphazela iinkqubo ezahlukeneyo zamalungu omzimba, ezifana nolusu, amalungu, izintso, kunye nengqondo.
• I-rheumatoid arthritis : Imeko echaphazela kakhulu amalungu, ibangela iintlungu nokudumba.
• Isifo sikaSjogren : Amehlo nomlomo owomileyo zezona mpawu ziphambili.
• Isifo se-thyroid : Ukungalingani kwiihomoni ze-thyroid.
• I-ulcerative colitis : Ukudumba kunye nokuvuvukala kwamathumbu amakhulu.
• Isifo sikaHashimoto : Imeko apho amajoni omzimba ehlasela i-thyroid gland.

Ngamanye amaxesha, i-AIHA inokubangelwa lusulelo lwentsholongwane . Nangona kunjalo, olu hlobo lokuphelelwa yigazi ludla ngokuba ngcono xa usulelo lwentsholongwane luphelile. Ezinye iintsholongwane ezinokunxulunyaniswa ne-AIHA ziquka:

• Intsholongwane ka-Epstein-Barr (intsholongwane ebangela i-mononucleosis)
• I-Mascus
• Iingqukuva
• I-Rubella
• I-pneumonia engaqhelekanga
• Intsholongwane yeVaricella, ebangela i-chickenpox
• `Intsholongwane kaGawulayo`
• I-Hepatitis (iintsholongwane ezichaphazela isibindi ngokukodwa)
• I-Cytomegalovirus `(i-Cytomegalovirus)`

Amanye amayeza anokubangela i-AIHA. Ukuba kurhanelwa ukuba kukho amayeza owasebenzisayo abangela le meko, ugqirha wakho angawuyeka loo mayeza.

• Ii-antibiotics (ingakumbi i-penicillin)
• Amayeza angengowe-steroidal alwa nokuvuvukala (ii-NSAID) (umz. i-ibuprofen)
• Amayeza okulwa nomhlaza

Ifunyaniswa njani i-AIHA?

Ukuba ugqirha wakho ukrokrela ukuba uneempawu ze-anemia, uya kuqala akuyalele ukubala igazi elipheleleyo (i-CBC) . Oku kunokubona iimpawu ezilumkisayo ze-anemia. Ngokukodwa, olu vavanyo lulinganisa:

• Zingaphi iiseli ezibomvu zegazi, iiseli ezimhlophe zegazi, kunye neeplatelets ezisegazini lakho.
• Ubungakanani beeseli zakho ezibomvu zegazi (ezinkulu, ezincinci, eziqhelekileyo).
• Inqanaba le-hemoglobin - Le yiproteni esegazini lakho ethwala ioksijini emzimbeni wakho wonke.
• Ixabiso leHematocrit (isithuba esingakanani esithathwa ziiseli zakho ezibomvu zegazi egazini lakho).

Ezinye iimvavanyo ezinokunceda ekuxilongeni i-AIHA

Ukuba ugqirha wakho urhanela ukuba une-anemia, uza kucebisa ezinye iimvavanyo ezimbalwa. Ezi mvavanyo zinokunceda ekuqinisekiseni ukuba i-anemia ibangelwa yi-AIHA okanye esinye isizathu.

• I-Peripheral smear: Oku kuquka ukuthatha isampuli yegazi lakho uze uyijonge phantsi kwe-microscope. Oku kunokujonga izinto ezifana nokuba iiseli zakho ezibomvu zegazi zonakele okanye zitshintshile na.
• Inani lee-reticulocyte: Olu vavanyo lulinganisa inani lee-red cells eziselula (ezisandula ukwakheka) emzimbeni wakho. Khumbula, xa ii-red cells zitshatyalaliswa, umongo wethambo uqala ukwenza ii-red cells ezininzi ukuze zithathe indawo yazo. Oku kwandisa inani lee-reticulocyte.
• Uvavanyo lweBilirubin: Xa iiseli ezibomvu zegazi zitshatyalalisiwe, kuveliswa into ebizwa ngokuba yibilirubin. Xa oku kusanda, kuvela i-jaundice (ukutyheli kolusu). Ngoko ke, ukuba inqanaba lebilirubin egazini liphezulu, luphawu lokuba iiseli ezibomvu zegazi ziyaqhekeka.
• Uvavanyo lukaCoombs: Olu luvavanyo olubaluleke kakhulu ekuxilongeni i-AIHA. Lujonga ukuba umzimba wakho uvelisa ii-antibodies ezichasene neeseli ezibomvu zegazi.
• Uvavanyo lweHaptoglobin: IHaptoglobin yiproteni esusa inkunkuma kwiiseli ezibomvu zegazi ezonakeleyo. Xa iiseli ezininzi ezibomvu zegazi zitshatyalaliswa, umzimba usebenzisa uninzi lwale haptoglobin. Oku kubangela ukuba inqanaba lehaptoglobin egazini lehle.
• I-Lactate dehydrogenase (LDH): I-LDH yi-enzyme efumaneka ngaphakathi kwiiseli ezibomvu zegazi. Xa iiseli ezibomvu zegazi zitshatyalalisiwe, le enzyme ye-LDH ikhutshwa egazini. Oku kubangela ukuba amanqanaba e-LDH anyuke.
• I-cold agglutinin titer: Ukuba ugqirha wakho urhanela ukuba kukho i-AIHA ebandayo, unokuyalela olu vavanyo. Oku kulinganisa inqanaba lee-antibodies ezihlasela iiseli ezibomvu zegazi kumaqondo obushushu abandayo.

Iphathwa njani i-AIHA?

Xa unyanga i-AIHA, inyathelo lokuqala lidla ngokufumanisa ukuba kukho unobangela ongonakaliswayo. Umzekelo, ukuba i-AIHA yakho inxulunyaniswa ne-lupus, ugqirha wakho uya kuqala anyange i-lupus. Ukuba unobangela we-AIHA yimeko efana ne-lymphoma, kubalulekile ukunyanga loo meko. Ukuba iyeza libangela i-AIHA yakho, kunokufuneka uyeke ukuyisebenzisa loo mayeza.

Nangona kunjalo, kwabanye abantu, i-AIHA ithambile kakhulu.Oko kuthetha ukuba iimpawu azikho qatha kangako. Ngelo xesha, akukho nyango lufunekayo.

Amayeza

• IiCorticosteroids: Ezi zihlala ziyindlela yokuqala yonyango lwe-AIHA. La mayeza asebenza ngokucinezela inkqubo yomzimba wakho yokuzikhusela, nto leyo enciphisa umonakalo owenzekayo kwiiseli zakho ezibomvu zegazi.
• Ii-immunosuppressants: Ukuba ii-corticosteroids zodwa azanele ukulawula isifo, ugqirha wakho unokukunika olu hlobo lwamayeza. La mayeza asebenza ngokuthintela inkqubo yomzimba yokuzikhusela ekuhlaseleni umongo wethambo.

I-Splenectomy (utyando lokususa i-spleen)

Ukuba i-AIHA ayinakulawulwa ngamayeza kuphela, kunokufuneka ukuba utyando lwakho lususe i-spleen. I-spleen sisitho esisemzimbeni wethu esihluza iiseli ezibomvu zegazi ezingaqhelekanga, njengeeseli ezibomvu zegazi ezinee-antibodies ezinamathele kuzo. I-spleen ikwanazo neeseli ezivelisa ii-antibodies. Ngoko ke ukususa i-spleen kunokunciphisa ukutshatyalaliswa kweeseli ezibomvu zegazi kunye nokunciphisa umngcipheko we-anemia.

Utofelo-gazi

Kwiimeko ezinzima ze-AIHA, izigulana zinokufuna utofelo-gazi, oluyitofelo-gazi oluvela ngaphandle. Oku kunokunyusa ngokukhawuleza inani leeseli ezibomvu zegazi kwaye kuncede ukulawula iimpawu.

Ngaba unyango lwe-AIHA 'eshushu' 'nebandayo' lwahlukile?

Ewe, unyango lwe-'AIHA ebandayo' yokuqala lwahlukile kwi-'AIHA efudumeleyo'.

Ii-corticosteroids okanye amayeza okunciphisa umzimba adla ngokusetyenziswa kwi-'AIHA efudumeleyo'. Ukuba oko akuphumelelanga, utyando lokususa i-spleen lunokufuneka. Kwimeko ye-anemia enzima, utofelo-gazi lukwathathwa njengonyango oluxhasayo ngelixa isifo sinyangwa.

Nangona kunjalo, 'i-cold AIHA' ayiphenduli kakuhle kwi-corticosteroids okanye kwi-splenectomy. Ukuba 'i-cold AIHA' incinci, esi sifo sinokulawulwa ngokugcina umzimba ufudumele (umz., ukusebenzisa izifudumezi zezandla/zeenyawo, ukunxiba iiglavu, iikawusi, mhlawumbi nokuya kwindawo efudumeleyo). Ukuba unyango luyimfuneko, iyeza elithi 'Rituximab' (ngamanye amaxesha kunye nezinye iziyobisi zokunciphisa umzimba) lolona nyango lokuqala.

Ngaba umngcipheko wokufumana i-AIHA ungancitshiswa?

I-Autoimmune Hemolytic Anemia ayinakuthintelwa rhoqo. Ngamanye amaxesha iyenzeka ngaphandle kwesizathu esicacileyo. Nangona kunjalo, ukuba unentsholongwane okanye uthatha amayeza aziwayo ukuba anxulumene ne-AIHA, ugqirha wakho unokujonga imeko yakho aze akuncede ukunciphisa umngcipheko wokufumana esi sifo.

Ingaba i-AIHA yimeko enzima?

I-Autoimmune Hemolytic Anemia ngamanye amaxesha incinci kangangokuba usenokungadingi naluphi na unyango. Nangona kunjalo, ngamanye amaxesha inokuba nzima kangangokuba unokufuna utyando okanye utofelo-gazi. Ukuba ufunyaniswe une-AIHA, ugqirha wakho angathetha nawe malunga nobunzima bemeko yakho kunye neendlela onokukhetha kuzo unyango.

Okubaluleke kakhulu, i-AIHA inokubulala ukuba ayinyangwa, yiyo loo nto ukungenelela ngokukhawuleza kwezonyango kubaluleke kangaka.

Ngaba i-AIHA inganyangeka?

Ewe. Uninzi lwabantu abane-AIHA aludingi unyango oluncinci okanye aludingi kwaphela. Phakathi kwama-20% nama-30% ezigulana zifuna amayeza, utyando, okanye utofelo-gazi.

Ndifanele ndimbone nini ugqirha?

Ukuba uqala ukuba neempawu ze-anemia - ezinje ngokudinwa kakhulu, ubuthathaka, i-jaundice (ulusu olutyheli), okanye ubunzima bokuphefumla - bonana nogqirha ngoko nangoko . Ngokufumana uxilongo kunye nonyango kwangethuba, ungaphila ngokukhawuleza kwaye ubuyele kubomi bakho besiqhelo.

Ngamafutshane (Umyalezo Wokuya Ekhaya)

I-Autoimmune Hemolytic Anemia (AIHA) yimeko apho inkqubo yakho yomzimba yokuzikhusela ihlasela iiseli zakho ezibomvu zegazi, nto leyo ebangela i-anemia.

• Iimpawu zinokuba zincinci okanye zibe nzima. Ukudinwa, ukuphaphatheka, inyongo, kunye nobunzima bokuphefumla zezona zinto ziphambili.
• Izizathu ziyahluka. Ngamanye amaxesha akukho sizathu sinokufunyanwa (esiphambili), ngamanye amaxesha sinokubangelwa zezinye izifo, usulelo, okanye amayeza (esibini).
• Kukho iindlela ezahlukeneyo zonyango . Ezi ziquka amayeza, ukususwa kwepleen, kunye notofelo-gazi. Unyango luyahluka ngokuxhomekeke kuhlobo 'lobushushu' kunye 'nolubandayo'.
• Nangona i-AIHA sisifo esilawulekayo , sinokuba yingozi, size sibulale , ukuba asinyangwa.

Ngoko ke, ukuba unezi mpawu, ungoyiki kwaye ungalibazisi, kodwa funa ingcebiso kagqirha. Ugqirha wakho angenza uvavanyo olufunekayo, axilonge ngokuchanekileyo imeko yakho, aze akunike unyango olufanelekileyo. Emva koko uya kukwazi ukuchacha ngokukhawuleza kwaye uqhubeke nemisebenzi yakho yemihla ngemihla!

i- autoimmune hemolytic anemia, i-AIHA, i-anemia, iiseli ezibomvu zegazi, ii-antibodies, inkqubo yomzimba yokuzikhusela, i-jaundice, ukudinwa