Zowonongeka
Nthenda yotchedwa Neonatal alloimmune thrombocytopenia (NAIT) ndi chikhalidwe chosawerengeka cha piritsi pakati pa mayi ndi mwana wake. Pakati pa mimba, mayi amapanga mankhwala omwe amamenyana ndi kuwononga mapaleletti omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda. Chimodzimodzi ndi Hemolytic Disease of Newborn, matenda a maselo ofiira a magazi.
NAIT sayenera kusokonezeka ndi neonatal autoimmune thrombocytopenia. Neonatal autoimmune thrombocytopenia amapezeka mwa amayi omwe ali ndi thrombocytopenia (ITP) kapena lupus. Mayiyo ali ndi majeremusi a mapuloteni omwe amasokoneza mapepala ake. Mankhwalawa amatumizidwa ku mwana wosabadwa kudzera m'matumbo omwe amachititsa kuti awonongeke.
Zizindikiro
Zizindikiro zimadalira chiwerengero cha platelet. Kawirikawiri mu mimba yoyamba, palibe mavuto mpaka mwanayo atabadwa. Mu sabata yoyamba, thrombocytopenia ikufalikira. Pamene mapulaneti akugwa, kuwonjezereka kwachulukidwe, petechiae (madontho ang'onoang'ono ofiira pakhungu), kapena kutuluka mwazi kumadziwika.
Kuvuta kwakukulu kwambiri kwa NAIT kumatuluka magazi mu ubongo wotchedwa intracranial hemorrhage (ICH). Izi zimachitika 10 - 20% a makanda. Ana omwe ali ndi chiwerengero chochepa kwambiri cha mapaleti amafufuzidwa kwa ICH ndi makina okhwima.
M'tsogolo mimba, thrombocytopenia ingakhale yoopsa ndipo ICH ikhoza kuchitika asanabadwe (pamene ali pachiberekero).
N'chifukwa Chiyani Izi Zikuchitika?
Mapulogalamu athu amadzala ndi antigen, zomwe zimayambitsa chitetezo cha mthupi. Mu NAIT, khanda limalandira cholowa cha apulole kuchokera kwa bambo omwe amayi alibe.
Matenda a amayi amateteza kuti antigen ndi "yachilendo" ndipo imayambitsa ma antibodies. Mankhwalawa amatumiziridwa kuchokera ku mayi kupita kumimba pamtunda kumene amaphatikiza ku mapuloleteni, kuwaika iwo kuti awonongeke. Mosiyana ndi Matenda a Hemolytic a Newborn, izi zikhoza kuchitika ndi mimba yoyamba yoyamba.
Kodi Zimapezeka Bwanji?
Pali mndandanda wautali wa zifukwa zomveka za thrombocytopenia mwana wakhanda. Zambiri mwazi ndizo chifukwa cha matenda monga congenital CMV , congenital rubella, kapena sepsis (matenda oopsa a bakiteriya). Nthawi zambiri, mwanayo akudwala kwambiri. NAIT iyenera kuonedwa ngati khanda looneka bwino lomwe liri ndi thrombocytopenia yoopsa (piritsi yowerengeka yosakwana 50,000 maselo pa microliter).
Mu NAIT mwana wakhanda amalandira mankhwala asanayambe kudziwa ngati akutsimikizira kuti matendawa amatenga milungu ingapo. Kuvomereza NAIT kumafuna kuyesa magazi, osati mwana. Mayiyo adzakhala ndi chiwerengero chokhala ndi tizilombo toyambitsa matenda ngati tizilombo toyambitsa matenda sitikumenyana ndi mapulaneti ake. Magazi amatumizidwa ku lai yapadera kuti aone ngati amayi ndi abambo akhala akunyalanyaza ma antitigeni a platelet ndipo ngati amayi akupanga antibodies kwa antigen platele yomwe imapezeka mwa abambo. Ngati NAIT akukayikira, ngati kuli kofunika kutsimikiza kuti mimba ya mtsogolo idzagwidwa ndi matenda aakulu kwambiri a thrombocytopenia ndi kuwonongeka kwa magazi mu utero (asanabadwe).
Kodi Ichi Chimachitika Motani?
Ana ocheperako pang'ono sangapange mankhwala. Pa ana okhudzidwa kwambiri, cholinga cha chithandizo ndikuteteza kapena kusiya kuika magazi, makamaka mu ubongo.
- Kupatsirana kwa Platelet: Chifukwa mapiritsi a mayi alibe antigen okhumudwitsa ndipo motero sudzawonongeka, ndiye kuti mapulateletsiti amatsitsidwa kwa mwanayo kapena kuchokera kwa wopereka ngati ofanana ndi mayiyo. Kuchita izi kungatenge nthawi yayitali ndipo sizothandiza nthawi zonse pamoyo weniweni. Ngati thrombocytopenia ndi yaikulu (
- Kutenga thupi kwa immune globulin (IVIG): IVIG ikhoza kulowa mu khanda kuti lisokoneze chitetezo cha mthupi. IVIG imakhala ndi ma antibodies ambiri ochokera kwa opereka ndalama zambiri. Mankhwalawa amatetezedwa kwambiri ndi chitetezo cha m'thupi ndipo amachepetsa kuwonongedwa kwa mapaleletti, mofanana ndi mankhwala a ITP. Izi zimagwiritsidwa ntchito palimodzi ndi platelet transfusions.
- Uphungu: Makolo omwe ali ndi mwana ndi NAIT ayenera kulangizidwa za chiopsezo cha izi zomwe zidzachitike mtsogolo. Chifukwa cha chiopsezo chimenechi, mimba yamtsogolo iyenera kuyang'aniridwa ndi munthu wodwalayo wodwalayo. IVIG ikhoza kuperekedwa kwa amayi nthawi yomwe mayiyo ali ndi mimba kapena kuperekera m'magazi angaperekedwe kwa mwana yemwe akukula kuti athetse magazi ochuluka. Gawo la Kaisara limalimbikitsidwa kuti abweretse magazi.
> Zolemba
> Karen S. Fernandez ndi Pedro de Alarcon. Neonatal Thrombocytopenia. NeoReviews. 2013.