Ingabe umzimba wakho uyawabhubhisa amangqamuzana akho abomvu egazi? Nakhu okudingeka ukwazi nge-Autoimmune Hemolytic Anemia (AIHA)!

Ingabe ngezinye izikhathi uzizwa ukhathele futhi ukhathele ngaphandle kwesizathu? Mhlawumbe isikhumba sakho sesiphenduke saba mhlophe noma siphuzi. Kunezikhathi lapho ungakwazi ukuthola ukuthi kungani lokhu kwenzeka, akunjalo? Esinye sezizathu zalezi zimpawu kungaba amasosha omzimba wakho, amasosha akuvikela ezifweni, ahlasela amangqamuzana akho abomvu egazi. Yilokho esikubiza ngokuthi 'i-Autoimmune Hemolytic Anemia' (AIHA) kwezokwelapha. Kalula nje, uhlelo lokuzivikela lomzimba wakho luphambanisa amangqamuzana akho abomvu egazi "njengesitha" futhi luwabhubhise. Nakuba lokhu kungathi sína kancane, kungaphathwa kahle ngokwelashwa okufanele . Kodwa-ke, uma kungelashwa, kungaba yingozi empilweni. Ngakho-ke, kubaluleke kakhulu ukuqaphela lokhu nokufuna iseluleko sezokwelapha ngokushesha okukhulu. Ake sixoxe ngalokhu ngokuningiliziwe.

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

Kalula nje, i-`Autoimmune Hemolytic Anemia` (AIHA) yisimo lapho isimiso sakho somzimba sokuzivikela sibona khona ngephutha amangqamuzana akho abomvu egazi “njengawangaphandle,” okusho into eyingozi emzimbeni. Ngenxa yalokho, umzimba wakho ukhiqiza amasosha omzimba abhubhisa amangqamuzana abomvu egazi. Lawa ma-antibodies anamathela kumaseli abomvu bese ewabhubhisa. Kwenzekani-ke? Inani lamangqamuzana abomvu egazi emzimbeni wakho liyancipha. Yilokho esikubiza ngokuthi “i-anemia.”

Cabanga nje, okwenzekayo lapha kufana nebutho elivikela izwe lethu, lihlasela ngephutha izakhamuzi zethu. Empeleni lokhu kuyinkimbinkimbi kancane, kodwa akunzima ukukuqonda.

Uyini umehluko phakathi kwe-AIHA eyinhloko neyesibili?

Kunezinhlobo ezimbili eziyinhloko ze-AIHA kuye ngokuthi zenzeka kanjani.

• I-AIHA Eyinhloko: Ngezinye izikhathi, i-AIHA ingavela ngaphandle kwesimo sezokwelapha esisobala. Lokhu kusho ukuthi odokotela abakwazi ukuthola ukuthi kungani yavela ngokuzumayo. Lokhu kubizwa ngokuthi i-AIHA eyinhloko.
• I-AIHA yesibili: Olunye uhlobo lwe-AIHA yilapho i-AIHA ibangelwa esinye isimo. Isibonelo, ingabangelwa izifo ezithile ezibangelwa amagciwane, izifo ezizimele (lapho amasosha omzimba ehlasela khona izicubu zawo), imithi ethile, noma umdlavuza wegazi ongaphansi njenge-lymphoma.

Yiziphi izinhlobo eziyinhloko ze-AIHA?

Kunezinhlobo ezimbili eziyinhloko ze-AIHA. Yi- "Warm autoimmune hemolytic anemia" kanye ne-"Cold autoimmune hemolytic anemia" . Lezi zihlukaniswa ngokohlobo lwama-antibodies ahilelekile kulesi sifo. Okusho ukuthi, igama lisuselwa ekushiseni lapho ama-antibodies ahlasela amaseli abomvu egazi eqala ukusebenza khona.

I-anemia ye-hemolytic ye-autoimmune efudumele

Lolu uhlobo oluvame kakhulu lwe-AIHA. Lapha, ama-antibodies ohlobo lwe-`IgG` abopha amaseli abomvu egazi. Into ekhethekile ukuthi la ma-antibodies asebenza ekushiseni okujwayelekile komzimba wethu (okungukuthi, endaweni "efudumele"). Izimpawu zivame ukuqala ukuvela kancane kancane, emavikini ambalwa. Kodwa-ke, kwezinye izimo, izimpawu zingaba zimbi ngisho naphakathi kwezinsuku ezimbalwa.

I-anemia ye-hemolytic ye-autoimmune ebandayo

Lolu hlobo lubonakala ku-10% kuya ku-20% kuphela weziguli ze-AIHA. Luhilela uhlobo lwe-autoantibody olubizwa ngokuthi `IgM`. Lawa ma-autoantibodies abopha kumaseli abomvu egazi uma igazi lakho lisezingeni lokushisa eliphansi kunezinga lokushisa lomzimba wakho, elibizwa ngokuthi ``kubanda''. Leli zinga lokushisa ``kubanda'' lingahluka kumuntu nomuntu. Lokhu kusho ukuthi kwabanye abantu, lawa ma-antibodies angase asebenze uma ebanda kancane, kanti kwabanye, kungadingeka ukuthi abanda kakhulu.

Ubani othinteka kakhulu yilesi simo se-AIHA?

I-AIHA ingakhula kunoma ubani, kungakhathaliseki ubudala noma ubulili. Kodwa-ke, lesi simo sivame kakhulu kwabesifazane abangaphezu kweminyaka engu-40 .

Nakuba ivame kangaka, i-AIHA iyisimo esingavamile . Sithinta cishe umuntu oyedwa noma ababili kwabayizinkulungwane eziyikhulu minyaka yonke.

Ziyini izimpawu ze-AIHA?

I-AIHA ingadala izimpawu ezahlukahlukene. Ezinye zivame kakhulu, kanti ezinye ziyahlukahluka kuye ngohlobo lwe-AIHA onalo.

Nazi ezinye izimpawu ezivamile:

• Imfiva
• Ukukhathala okukhulu (ukukhathala kakhulu ukwenza noma yini kahle)
• Ubuthakathaka
• Ukushaya kwenhliziyo
• Ubunzima bokuphefumula (ngisho noma uzikhandla kancane)
• Isikhumba esiphaphathekile (njengalapho unesifo somfutho wegazi esiphansi)
• I-jaundice (ukuphuzi kwesikhumba namehlo)
• Ikhanda elibuhlungu (ikhanda elibuhlungu)
• Ubuhlungu bemisipha
• Umchamo omnyama (njengamanzi etiye)
• Ukuhlanza kanye nesicanucanu
• Ukuphelelwa umoya
• Uhudo
• Ukulimala kolimi
• Ukushaya kwenhliziyo (ukuzwa inhliziyo yakho ishaya kakhulu kangangokuthi ungayizwa)

Khumbula, ukuba nesinye noma ezimbili zalezi zimpawu akusho ukuthi une-AIHA. Kodwa uma lezi zimpawu ziqhubeka, kungcono ukubona udokotela.

Izimpawu zingahluka, ikakhulukazi kuye ngohlobo lwe-AIHA:

I-AIHA efudumele ivame ukubonakala ku:

• Ukukhathala
• Isiyezi
• I-jaundice (ukuphuzi kwesikhumba)
• Ukuzwa ukushaya kwenhliziyo

I-AIHA ebandayo ingabangela izimpawu ezifana nalezi:

• Ukukhathala
• Isiyezi
• Izandla nezinyawo ezibandayo (ukuzizwa ubanda kakhulu kunezinye)
• I-Jaundice
• Ubuhlungu besifuba
• Ubuhlungu ngemuva kwemilenze
• Isifo sikaRaynaud (isimo lapho iminwe nezinzwane ziphenduka zibe mhlophe/ziluhlaza okwesibhakabhaka futhi zibe ndikindiki uma zibekwe emakhazeni)
• Ukushintsha kombala wezandla nezinyawo okuluhlaza okwesibhakabhaka
• Ukuphazamiseka kwenhliziyo `(Arrhythmia)`
• Ukuzwa inhliziyo ikhala
• Ukwehluleka kwenhliziyo (lokhu kwenzeka ezimweni ezinzima kakhulu)

Yiziphi izimbangela ze-AIHA?

Cishe engxenyeni yazo zonke iziguli ezine-AIHA (cishe ama-50%), imbangela eqondile ayitholakali . Lokhu sikubiza ngokuthi "i-idiopathic autoimmune hemolytic anemia." Lokho kusho ukuthi "ayikho imbangela eyaziwayo."

Ngakolunye uhlangothi, i-AIHA ihlotshaniswa nezinye izimo zezokwelapha.

Ezinye izimo zezokwelapha ezingabangela i-AIHA zifaka:

Kunezifo eziningana zokuzivikela komzimba ezingabangela i-AIHA yesibili. Okungukuthi, ezinye izifo lapho amasosha omzimba ehlasela khona amangqamuzana omzimba aphilile.

• I-Lupus : Lesi yisifo esingathinta izinhlelo ezahlukene zezitho zomzimba, njengesikhumba, amalunga, izinso kanye nobuchopho.
• I-rheumatoid arthritis : Isimo esithinta kakhulu amalunga, okubangela ubuhlungu nokuvuvukala.
• I-Sjogren's syndrome : Amehlo nomlomo owomile yizimpawu eziyinhloko.
• Isifo se-thyroid : Ukungalingani kwama-hormone e-thyroid.
• I-ulcerative colitis : Ukuvuvukala kanye nokuvela kwezilonda emathunjini.
• Isifo sikaHashimoto : Isimo lapho amasosha omzimba ehlasela khona indlala yegilo.

Ngezinye izikhathi, i-AIHA ingabangelwa ukutheleleka ngegciwane . Kodwa-ke, lokhu kuntuleka kwegazi kuvame ukuthuthuka uma ukutheleleka ngegciwane sekuxazululiwe. Amanye amagciwane angase ahlotshaniswe ne-AIHA afaka:

• Igciwane le-Epstein-Barr (igciwane elibangela i-mononucleosis)
• Isimungumungwane
• Ama-mumps
• I-Rubella
• I-pneumonia engavamile
• Igciwane le-Varicella, elibangela i-chickenpox
• `Igciwane lengculazi`
• I-Hepatitis (amagciwane athinta isibindi ngqo)
• I-Cytomegalovirus

Eminye imithi ingabangela ne-AIHA. Uma kusolwa ukuthi umuthi owuthathayo ubangela lesi simo, udokotela wakho angase awuyeke.

• Ama-antibiotic (ikakhulukazi i-penicillin)
• Imithi engeyona eye-steroidal elwa nokuvuvukala (ama-NSAID) (isib. i-ibuprofen)
• Imithi yokulwa nomdlavuza

Itholakala kanjani i-AIHA?

Uma udokotela wakho esola ukuthi unezimpawu ze-anemia, uzoqala ngokuyalela ukubalwa kwegazi okuphelele (i-CBC) . Lokhu kungathola izimpawu eziyisixwayiso ze-anemia. Ngokukhethekile, lokhu kuhlolwa kulinganisa:

• Mangaki amangqamuzana abomvu egazi, amangqamuzana amhlophe egazi, nama-platelet egazini lakho.
• Usayizi wamaseli akho abomvu egazi (amakhulu, amancane, ajwayelekile).
• Izinga le-hemoglobin - Lena yiprotheni egazini lakho ethwala umoya-mpilo emzimbeni wakho wonke.
• Inani le -hematocrit (isikhala esingakanani esithathwa amaseli akho abomvu egazini lakho).

Ezinye izivivinyo ezingasiza ekuxilongeni i-AIHA

Uma udokotela wakho esola ukuthi une-anemia, uzoncoma ukuhlolwa okumbalwa okwengeziwe. Lokhu kuhlolwa kungasiza ekunqumeni ukuthi ngabe i-anemia ibangelwa yi-AIHA noma enye imbangela.

• I-Peripheral smear: Lokhu kuhilela ukuthatha isampula yegazi lakho bese ulibheka ngaphansi kwe-microscope. Lokhu kungabheka izinto ezifana nokuthi amaseli akho abomvu egazi onakele noma ashintshe isimo.
• Inani lama-reticulocyte: Lokhu kuhlolwa kulinganisa inani lamaseli abomvu egazi amancane (asanda kwakheka) emzimbeni wakho. Khumbula, lapho amaseli abomvu ebhujiswa, umnkantsha uqala ukwenza amaseli abomvu egazi amaningi ukuze awathathe indawo yawo. Lokhu kwandisa inani lama-reticulocyte.
• Ukuhlolwa kwe-Bilirubin: Lapho amangqamuzana abomvu ebhujiswa, kukhiqizwa into ebizwa ngokuthi i-bilirubin. Uma lokhu kwanda, kuvela i-jaundice (ukuphuzi kwesikhumba). Ngakho-ke, uma izinga le-bilirubin egazini liphezulu, kuyisibonakaliso sokuthi amangqamuzana abomvu egazi ayaqhekeka.
• Ukuhlolwa kukaCoombs: Lokhu ukuhlolwa okubaluleke kakhulu ekuxilongeni i-AIHA. Kuhlola ukuthi umzimba wakho ukhiqiza yini ama-antibodies ngokumelene namaseli abomvu egazi.
• Ukuhlolwa kwe-Haptoglobin: I-Haptoglobin iyiprotheni esusa imfucuza emangqamuzaneni egazi abomvu awonakele. Uma amangqamuzana amaningi egazi abomvu ebhujiswa, umzimba usebenzisa iningi lale haptoglobin. Lokhu kubangela ukuthi izinga le-haptoglobin egazini lehle.
• I-Lactate dehydrogenase (LDH): I-LDH iyi-enzyme etholakala ngaphakathi kwamaseli abomvu egazi. Lapho amaseli abomvu ebhujiswa, le enzyme ye-LDH ikhishwa egazini. Lokhu kubangela amazinga e-LDH akhuphuke.
• I-Cold agglutinin titer: Uma udokotela wakho esola ukuthi i-AIHA ibanda, angase akucele lokhu kuhlolwa. Lokhu kulinganisa izinga lama-antibodies ahlasela amangqamuzana abomvu egazi emazingeni okushisa abandayo.

Iphathwa kanjani i-AIHA?

Uma welapha i-AIHA, isinyathelo sokuqala ngokuvamile ukuthola ukuthi kukhona yini imbangela eyisisekelo engelashwa. Isibonelo, uma i-AIHA yakho ihlotshaniswa ne-lupus, udokotela wakho cishe uzolapha i-lupus kuqala. Uma imbangela ye-AIHA kuyisimo esifana ne-lymphoma, kubalulekile ukwelapha leso simo. Uma umuthi ubangela i-AIHA yakho, kungadingeka uyeke ukuthatha lowo muthi.

Kodwa-ke, kwabanye abantu, i-AIHA imnene kakhulu.Lokho kusho ukuthi izimpawu azizimbi kangako. Ngaleso sikhathi, kungase kungabi khona ukwelashwa okudingekayo.

Imithi

• Ama-Corticosteroids: Lawa ngokuvamile ayindlela yokuqala yokwelapha i-AIHA. Le mithi isebenza ngokucindezela amasosha omzimba wakho, bese kunciphisa inani lomonakalo eliwenzayo kumaseli akho abomvu egazi.
• Ama-immunosuppressants: Uma ama-corticosteroids kuphela enganele ukulawula lesi sifo, udokotela wakho angase akunike lolu hlobo lwemithi. Lokhu kusebenza ngokuvimbela amasosha omzimba ekuhlaseleni umongo wamathambo.

I-Splenectomy (ukuhlinzwa kokususa umpempe)

Uma i-AIHA ingenakukwazi ukulawulwa ngemithi yodwa, kungadingeka ukuthi uhlinzwe ukususwa kwe-spleen yakho. I-spleen iyisitho emzimbeni wethu esihlunga amangqamuzana abomvu egazi angajwayelekile, njengamaseli abomvu egazi anama-antibodies anamathele kuwo. I-spleen iqukethe namaseli akhiqiza ama-antibodies. Ngakho-ke ukususa i-spleen kunganciphisa ukubhujiswa kwamangqamuzana abomvu egazi futhi kunciphise ingozi ye-anemia.

Ukumpontshelwa igazi

Ezimweni ezimbi kakhulu ze-AIHA, iziguli zingadinga ukumpontshelwa igazi, okuwukumpontshelwa igazi okuvela emithonjeni yangaphandle. Lokhu kungandisa ngokushesha inani lamaseli abomvu egazi futhi kusize ekulawuleni izimpawu.

Ingabe ukwelashwa kwe-AIHA 'efudumele' 'nebandayo' kuhlukile?

Yebo, ukwelashwa kwe-'AIHA ebandayo' eyinhloko kuhlukile kune-'AIHA efudumele'.

Ama-corticosteroids noma imithi yokucindezela amasosha omzimba ngokuvamile asetshenziselwa 'i-AIHA efudumele'. Uma lokho kungaphumeleli, ukuhlinzwa kokususa ubende kungadingeka. Ezimweni zokuntuleka kwegazi okukhulu, ukumpontshelwa igazi nakho kubhekwa njengokwelashwa okusekelayo ngenkathi lesi sifo selashwa.

Kodwa-ke, 'i-cold AIHA' ayiphenduli kahle kuma-corticosteroids noma ku-splenectomy. Uma 'i-cold AIHA' ilula, lesi sifo singalawulwa ngokugcina umzimba ufudumele (isib., ukusebenzisa ama-warmer ezandla/ezinyawo, ukugqoka amagilavu, amasokisi, futhi mhlawumbe nokuya endaweni efudumele). Uma ukwelashwa kuyadingeka, umuthi 'i-Rituximab' (ngezinye izikhathi neminye imithi yokucindezela amasosha omzimba) uwukwelashwa kokuqala.

Ingabe ingozi yokuthola i-AIHA ingancishiswa?

I-Autoimmune Hemolytic Anemia ayikwazi ukuvinjelwa ngaso sonke isikhathi. Ngezinye izikhathi kwenzeka ngaphandle kwesizathu esibonakalayo. Kodwa-ke, uma unegciwane noma uthatha imithi eyaziwa ukuthi ihlotshaniswa ne-AIHA, udokotela wakho angaqapha isimo sakho futhi asize ekunciphiseni ingozi yakho yokuthola lesi sifo.

Ingabe i-AIHA iyisimo esibucayi?

I-Autoimmune Hemolytic Anemia ngezinye izikhathi incane kakhulu kangangokuthi ungase ungadingi ukwelashwa. Kodwa-ke, ngezinye izikhathi ingaba nzima kakhulu kangangokuthi ungase udinge ukuhlinzwa noma ukumpontshelwa igazi. Uma kutholakala ukuthi une-AIHA, udokotela wakho angakhuluma nawe ngobunzima besimo sakho kanye nezinketho zakho zokwelapha.

Okubaluleke kakhulu, i-AIHA ingaba yingozi uma ingelashwa, yingakho ukungenelela kwezokwelapha ngokushesha kubaluleke kangaka.

Ingabe i-AIHA ingelapheka?

Yebo. Iningi labantu abane-AIHA lidinga ukwelashwa okuncane noma abakudingi nhlobo. Phakathi kuka-20% no-30% weziguli zidinga imithi, ukuhlinzwa, noma ukumpontshelwa igazi.

Kufanele ngimbone nini udokotela?

Uma uqala ukuzwa izimpawu ze-anemia – njengokukhathala okukhulu, ubuthakathaka, i-jaundice (ukuguquka kwesikhumba kube phuzi), noma ubunzima bokuphefumula – bonana nodokotela ngokushesha . Ngokuthola ukuxilongwa nokwelashwa kusenesikhathi, ungalulama ngokushesha futhi ubuyele empilweni yakho evamile.

Ngamafuphi (Umyalezo Wokuya Ekhaya)

I-Autoimmune Hemolytic Anemia (AIHA) yisimo lapho amasosha omzimba wakho ehlasela khona amangqamuzana akho abomvu egazi, okubangela i-anemia.

• Izimpawu zingaba zincane noma zibe zimbi kakhulu. Ukukhathala, ukuphaphatheka, i-jaundice, kanye nobunzima bokuphefumula yizona eziyinhloko.
• Izimbangela ziyahlukahluka. Ngezinye izikhathi azikho izizathu ezingatholakala (eziyinhloko), ngezinye izikhathi zingabangelwa ezinye izifo, izifo, noma imithi (yesibili).
• Kunezindlela eziningana zokwelapha . Lokhu kufaka phakathi imithi, ukususwa kobende, kanye nokumpontshelwa igazi. Ukwelashwa kuyahlukahluka kuye ngohlobo 'lokufudumala' kanye 'nolubandayo'.
• Nakuba i-AIHA iyisifo esilawulekayo kakhulu , ingaba yingozi kakhulu, ngisho nokuphila , uma ingelashwa.

Ngakho-ke, uma unalezi zimpawu, ungesabi futhi ungalibali, kodwa funa iseluleko sezokwelapha. Udokotela wakho angenza izivivinyo ezidingekayo, ahlole ngokunembile isimo sakho, futhi akunikeze ukwelashwa okufanele kakhulu. Khona-ke uzokwazi ukululama ngokushesha futhi uqhubeke nemisebenzi yakho yansuku zonke!

i- autoimmune hemolytic anemia, i-AIHA, i-anemia, amaseli abomvu egazi, ama-antibodies, isimiso somzimba sokuzivikela, i-jaundice, ukukhathala