Ingabe nawe uzizwa ukhathele ngaso sonke isikhathi? Ingabe uyaba nesiyezi ngisho nangemva kokuhamba isikhashana? Ingabe isikhumba sakho ngezinye izikhathi siyashintsha umbala bese sibukeka siphuzi? Lokhu kungaba izimpawu ze-anemia evamile. Kodwa ngezinye izikhathi kunendaba eyinkimbinkimbi ngemuva kwayo. Kuyisimo esingavamile lapho uhlelo lokuzivikela lomzimba wakho luqala khona impi ngokumelene namaseli akho egazi. Yilokho esikhuluma ngakho namuhla.
Kuyini i-Autoimmune Hemolytic Anemia (AIHA)?
Kalula nje, i-Autoimmune Hemolytic Anemia (AIHA) yisimo lapho amasosha omzimba wethu ehlasela futhi abhubhise ngamaphutha amangqamuzana ethu abomvu egazi anempilo.
Cabanga ngakho, amangqamuzana ethu abomvu egazi ayizimoto ezincane ezithwala umoya-mpilo emzimbeni wonke. Akhiqizwa efektri ebizwa ngokuthi umnkantsha wamathambo ngaphakathi kwamathambo ethu. Ngokwesilinganiso, iseli elibomvu legazi liphila cishe izinsuku ezingu-120.
Kodwa kumuntu one-AIHA, isimiso somzimba sokuzivikela, esifana nesimiso sokuzivikela somzimba, sibona la maseli abomvu egazi njengamaseli esitha. Bese kuthi, la masistimu okuzivikela, okungukuthi, ama-antibodies, abambe futhi abhubhise la maseli abomvu egazi. Izinga lalokhu kubhujiswa lishesha kakhulu kunalokho umnkantsha ongakwakha amangqamuzana amasha egazi abomvu. Ngezinye izikhathi, iseli okufanele liphile izinsuku ezingu-120 liyabhujiswa ezinsukwini ezimbalwa nje. Ngakho-ke, umzimba awutholi inani elidingekayo lomoya-mpilo futhi izimpawu ezifana nokukhathala nobuthakathaka ziqala ukuvela.
Yiziphi izinhlobo eziyinhloko ze-AIHA?
I-AIHA ihlukaniswe kakhulu ngezinhlobo ezimbili, kuye ngokuthi umzimba usabela kanjani ekushiseni.
- I-Warm Autoimmune Hemolytic Anemia: Lolu uhlobo oluvame kakhulu. Kulokhu, amasosha omzimba abhubhisa amangqamuzana abomvu egazi lapho izinga lokushisa lomzimba noma ngaphezulu kwelejwayelekile. Lokhu kubangelwa uhlobo oluthile lwe-antibody olubizwa nge-IgG.
- I-Cold Autoimmune Hemolytic Anemia (Isifo se-Cold Agglutinin - CAD): Lolu uhlobo olungavamile kakhulu. Kulokhu, amangqamuzana abomvu egazi ayabhujiswa lapho umzimba ubhekene nokubanda. Ngokuvamile emazingeni okushisa aphansi njengo-3-4 degrees Celsius. Lokhu kubangelwa uhlobo lwe-antibody olubizwa nge-IgM.
Into ebalulekile ukuthi, lesi akusona isifo esithelelanayo. Awukwazi ukusithola komunye umuntu, futhi awukwazi ukusidlulisela komunye umuntu. Kodwa-ke, ezinye zezifo ezibangelwa amagciwane ezingadala lesi sifo zingathelelana.
Ziyini izimpawu zalesi sifo?
Izimpawu eziningi ze-AIHA zifana neze-anemia evamile. Abanye abantu bangase bangabi nazo nhlobo izimpawu.
| Isibonakaliso | Incazelo |
|---|---|
| Ukukhathala nobuthakathaka | Uphawu oluvame kakhulu ukuntuleka komoya-mpilo emzimbeni. |
| Inhliziyo esheshayo (i-Tachycardia) | Ngoba inhliziyo isebenza ngokushesha ukuze ibuyisele ukuntuleka komoya-mpilo. |
| Ubunzima bokuphefumula (ukuphelelwa umoya) | Ikakhulukazi uma wenza imisebenzi emincane noma uhamba ngezinyawo. |
| Ukuphaphathekile noma ukuphuzi kwesikhumba namehlo (i-Jaundice) | I-Bilirubin, into ekhiqizwa lapho amangqamuzana abomvu egazi ewohloka, ibangela isikhumba kanye namhlophe emehlweni ukuba aphenduke aphuzi. |
| Umchamo omnyama | Umchamo onombala wamanzi etiye noma i-cola. |
| Ubende Okhulisiwe | Ubende lungavuvukala futhi luzizwe luvuvukele njengoba lusebenza isikhathi esengeziwe ukususa amangqamuzana egazi abomvu abonakele. |
| Ngaphezu kwalokhu, labo abane-Cold AIHA (CAD)... | |
| Izandla nezinyawo ezibandayo kanye nokushintsha kombala | Ukushintsha kombala weminwe nezinzwane okuluhlaza okwesibhakabhaka noma okubomvu uma kuvezwa emakhazeni. |
| Ikhanda elibuhlungu kanye nobuhlungu emhlane | Umkhuhlane ungabangela ukuphazamiseka kokujikeleza kwegazi. |
Yini ebangela i-AIHA?
Ngezinye izikhathi akukho sizathu esithile esingatholakala. Lokhu sikubiza ngokuthi i-AIHA Eyinhloko. Kodwa kaningi kungabangelwa esinye isimo sezokwelapha noma imithi (i-Secondary AIHA).
Kunezizathu eziningana eziyinhloko:
- Ezinye izifo zokuzivikela komzimba: Abantu abanezinye izifo zokuzivikela komzimba, njenge-lupus, basengozini yokuthola i-AIHA.
- Izinhlobo ezithile zomdlavuza: ikakhulukazi umdlavuza ohlobene negazi njenge- (Chronic Lymphocytic Leukemia) kanye ne- (Non-Hodgkin Lymphoma) .
- Ukutheleleka ngegciwane kanye namagciwane: Ukutheleleka okufana negciwane le-Epstein-Barr (igciwane elibangela i-mononucleosis, efana nomkhuhlane), i-Cytomegalovirus , i-HIV , kanye ne-Mycoplasma pneumoniae .
- Imithi ethile: Eminye imithi elwa namagciwane (isib. i-penicillin) kanye neminye imithi nayo ingabangela lesi simo. Ngakho-ke, kubaluleke kakhulu ukutshela udokotela wakho ngayo yonke imithi oyiphuzayo.
Wazi kanjani ukuthi une-AIHA?
Uma unalezi zimpawu, qiniseka ukuthi ubona udokotela wakho . Uzokubuza ngezimpawu zakho, imithi oyiphuzayo, bese ekuxilonga. Uma kudingeka, bazokudlulisela kudokotela wegazi.
Ukuhlolwa kwegazi okuningana kwenziwa ikakhulukazi ukuqinisekisa i-AIHA.
- Ukubalwa Kwegazi Okuphelele (i-CBC): Lokhu kuhlola inani lamaseli akho abomvu egazi, amaseli amhlophe egazi, kanye nama-platelet. Inani eliphansi lamaseli abomvu egazi liwuphawu lwe-anemia.
- Ukucwiliswa Kwegazi: Isampula yegazi ihlolwa ngaphansi kwe-microscope ukuze kubonwe ukuma kwamangqamuzana egazi abomvu nokuthi alimele yini.
- Inani lama-reticulocyte: Lokhu kulinganisa inani lamaseli abomvu egazi angakavuthwa akhiqizwa umnkantsha. Uma leli nani liphezulu, kusho ukuthi umnkantsha usebenza kanzima kakhulu ukwenza amaseli amasha ukuze athathe indawo yalawo abhujiswayo.
- Ukuhlolwa kukaCoombs: Lokhu ukuhlolwa okubaluleke kakhulu kokuxilonga i-AIHA. Kunganquma ukuthi umzimba wakho ukhiqiza yini ama-antibodies ngokumelene namaseli abomvu egazi.
- Ezinye izivivinyo: Ngaphezu kwalokho, izivivinyo ezifana neBilirubin neHaptoglobin zingenziwa.
Yiziphi izindlela zokwelapha i-AIHA?
Uma isimo sakho singesibi kakhulu, ungase ungadingi ukwelashwa. Kodwa-ke, kufanele ube ngaphansi kokubhekwa njalo ngudokotela. Uma kunezimpawu noma uma i-anemia inzima, kuzoqalwa ukwelashwa.
- Ama-Steroids: Ama-Steroids, njenge-prednisolone, ayindlela yokuqala yokwelapha. Lawa acindezela isimiso somzimba sokuzivikela esisebenza ngokweqile futhi ayeke ukubhujiswa kwamangqamuzana abomvu egazi.
- Eminye imithi elawula amasosha omzimba (Ama-Immunosuppressants): Uma lesi sifo singaphenduli kuma-steroid, kusetshenziswa imithi efana ne-Rituximab ne-Azathioprine.
- Ukususwa kwe-splenectomy: Ezimweni lapho imithi ingasebenzi kahle, ikakhulukazi ku-AIHA efudumele, i-spleen, okuyindawo lapho iningi lamaseli abomvu egazi libhujiswa khona, isuswa ngokuhlinzwa.
- Ukufakwa Kwegazi: Uma i-anemia inzima kakhulu futhi isongela ukuphila, kungadingeka ukumpontshelwa igazi.
- Amavithamini kanye nezithako zokudla okunempilo: Udokotela wakho angase ancome izinto ezifana ne-folic acid, edingekayo ukuze kwenziwe amangqamuzana abomvu egazi. Ungalokothi uthathe noma yimaphi amavithamini ngaphandle kokubonisana nodokotela wakho.
Iseluleko esikhethekile kulabo abane-Cold AIHA
Uma unohlobo oluzwela kakhulu emakhazeni, kubaluleke kakhulu ukuzivikela emakhazeni .
- Gqoka amagilavu uma ukhipha izinto esiqandisini noma efrijini.
- Uma uphuma ngezinsuku ezibandayo, gqoka kahle, gqoka isigqoko, kanye ne-muffler.
- Ungayinciphisi kakhulu i-AC ekhaya.
- Ngaphambi kokungena emotweni ngosuku olubandayo, yiqale isikhashana bese uvumela ingaphakathi lemoto lifudumale.
Yiziphi izinkinga ezingaba khona uma zingelashwa?
Uma i-AIHA ingalawulwa, kungaba nezinkinga ezinkulu.
- Amahlule Egazi: Kunengozi enkulu yokuqhekeka kwegazi, ikakhulukazi emilenzeni nasemaphashini. Ukuqhekeka kwegazi emaphashini (Pulmonary Embolism) kungaba yingozi empilweni.
- Isifo senhliziyo: Ukuntuleka kwegazi isikhathi eside kungenza inhliziyo ibe buthaka njengoba inhliziyo kufanele isebenze kanzima.
- Ukulimala kwezinso: Ukubhujiswa ngokweqile kwamangqamuzana abomvu egazi kungabangela ukulimala kwezinso.
Umlayezo Wokuya Nawe Ekhaya
- I-Autoimmune Hemolytic Anemia (AIHA) yisimo lapho amasosha omzimba wakho ebhubhisa khona amaseli akho abomvu ngephutha.
- Uma unezimpawu ezifana nokukhathala okungazelelwe, isiyezi, noma ukuphuzi kwesikhumba noma amehlo, ungakuzibi futhi ubone udokotela ngokushesha.
- Lesi akusona isifo esithathelwanayo. Ngakho-ke, asikho isidingo sokuzihlukanisa noma sokwesaba isiguli.
- Nakuba lesi simo singelapheki ngokuphelele, kunezindlela zokwelapha ezisebenza kahle kakhulu ezingasiza ekulawuleni lesi sifo futhi zikuvumele ukuthi uphile impilo evamile.
- Kubaluleke kakhulu ukulandela imiyalelo kadokotela ngqo, uphuze imithi yakho njengoba uyalelwe, futhi udle ukudla okunempilo.
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