Pakati pa kafukufuku wamankhwala wa mwana wanu wazaka chimodzi si zachilendo kuti mwana wanu adziitanitse kuwerengera kwathunthu kwa magazi (CBC) . CBC iyi imagwiritsidwa ntchito poyang'ana kufooka kwa magazi kwachitsulo monga ana kusintha kuchokera mkaka wa m'mawere kapena mkaka wa mkaka wonse. Mutha kudabwa pamene ofesi ya ana anu akuitanani kuti akudziwitse kuti mwana wanu alibe matenda ochepa koma kuti maselo awo oyera amagazi, makamaka magulu omenyera mabakiteriya otchedwa neutrophils, ali otsika.
Panthawiyi, mukhoza kumangokhala ndi mantha ndikudzifunsa kuti ndi chani.
Mwamwayi, chifukwa chofala cha neutropenia (chiwerengero chochepa cha neutrophil) mwa ana ndi kachilombo ka HIV. Pa matenda a mavairasi, kupanga kwa neutrophils kuchepetsedwa, komwe kungapangitse neutropenia. Matendawa atatha, chiwerengero cha neutrophil chimabwereranso kwachibadwa, kotero adokotala a ana angakulimbikitseni kubwereza CBC mu sabata limodzi kapena awiri. Ngati neutropenia ikupitirira, mwana wanu akhoza kutumizidwa kwa katswiri wamatenda kuti adziwe chifukwa cha neutropenia.
Kodi Vuto la Pachipatala N'chiyani?
Mankhwala otchedwa autoimmune neutropenia angathenso kutchedwa kuti matenda oopsa a ubongo. Matendawa ali ofanana ndi matenda a thrombocytopenia (ITP) komanso kutaya magazi m'thupi mwawo (AIHA) . Ngakhale kuti fupa la mafupa limapangitsa ma neutrophils kukhala osowa, thupi molakwika limapangitsa antibodies kukhala ndi neutrophils omwe amawaika iwo kuti awonongeke, zomwe zimayambitsa neutropenia.
Matendawa amadzipereka kwa ana 6 mpaka 15 ali ndi miyezi khumi koma akhoza kuchitika pa msinkhu uliwonse, ngakhale kukhala wamkulu. Kusintha kwadzidzidzi kwa neutropenia kuphatikiza ndi ITP kapena AIHA amatchedwa Evans Syndrome .
Zizindikiro
Ana ambiri omwe ali ndi neutropenia okhaokha alibe zizindikiro. Izi ziri choncho, ngakhale kuti chiwerengero chochepa cha neutrophil chiwerengero, matenda aakulu ndi osowa.
The neutropenia ikhoza kupezeka pa CBC yomwe imadutsa chachiwiri kupita ku khutu kapena kupuma. Ana ena amatha kumva zilonda zam'kamwa kapena matenda a khungu.
Kudziwa
Mofanana ndi mitundu ina ya neutropenia, mayesero oyambirira a kuyezetsa magazi ndi CBC. Chiwerengero chonse cha neutrophil (ANC) chimakhala pansi pa maselo 1000 pa microliter ndipo chikhoza kukhala pansi pa 500. Kawirikawiri, hemoglobini ndi chiwerengero cha mbale zimakhala zachilendo. Kachilombo ka magazi kameneka, kukayezetsa maselo a magazi pansi pa microscope, kungathenso kukodwa. Ngakhale chiwerengero cha neutrophils chiri chochepa, amakhala ndi mawonekedwe abwino.
Kenaka, dokotala wanu angapeze CBC kawiri mlungu uliwonse kwa masabata asanu ndi limodzi kuti atsimikizire kuti mwana wanu alibe cyclic neutropenia (vuto limene neutrophils liri lochepa kwa masiku angapo masiku 21).
Dokotala wanu angatumize kukayezetsa kuti adziwe ngati pali antibodies kwa neutrophils, kuzilemba iwo ku chiwonongeko. Ngati mayesowa ali othandiza, amatsimikizira kuti ali ndi vutoli. Mwamwayi, ngati mayeserowa ndi olakwika sichilamulira okhaokha. Odwala ena, anti-neutrophil antibodies sadziwika. Pazochitikazi, ngati msinkhu ndi kufotokozera zimagwirizana ndi chithunzi cha autoimmune neutropenia, chidziwitso chimawerengedwa.
Nthawi zambiri, kuyezetsa mafupa a mafupa kungakhale kofunikira kuti tipewe zifukwa zina za neutropenia. Izi zimachitika mwa ana omwe mautanidwe awo ndi zofooka sizigwirizana ndi chithunzi cha ana omwe akudwala matendawa.
Chithandizo
Palibe mankhwala enieni omwe amachititsa kuti asakhale ndi neutropenia aunyamata. Mankhwala odana ndi neutrophil amatha kupezeka mosavuta ndipo chiwerengero cha neutrophil chidzabwerenso mwachibadwa. Kutha msinkhu kumakhala ndi zaka zisanu, ndi neutropenia yomwe imatha pa miyezi 20.
Chifukwa neutropenia imachulukitsa chiopsezo chotenga matenda, nthenda zonse zimafuna kuchipatala.
Izi kawirikawiri zimakhala ndi CBC, chikhalidwe cha magazi (kuika magazi mu mabotolo a magalasi kufunafuna mabakiteriya), komanso mlingo umodzi wa mankhwala opha tizilombo. Ngati ANC ili yosachepera 500 maselo / mL, mwana wanu angaloledwe kuchipatala pa ma antibayotiki achinayi kuti awone. Ngati mwana wanu akuwoneka bwino ndipo ANC ili yaikulu kuposa 1000 / mL, mumatha kumasulidwa kuti mukapite kuchipatala.
Mankhwala omwe amagwiritsidwa ntchito pa matenda ena a chitetezo cha m'magazi (ITP, AIHA) monga steroids ndi intravenous immune globulin (IVIG) sali opambana pokhapokha ndi neutropenia. Nthawi zina filgrastim (G-CSF) ingagwiritsidwe ntchito pa matenda opatsirana pofuna kutulutsa ma neutrophils ku fupa la mafupa kupita ku magazi.
Zotsatira
Coates TD. Immunitropenia. Mu UpToDate, Post TW (Ed), UpToDate, Waltham, MA.