Isifo sehemolytic-uremic

Ukuveliswa kwetyhefu efana neShiga E coli I-hemolytic-uremic syndrome (STEC-HUS) sisifo esihlala senzeka xa usulelo kwinkqubo yokwetyisa luvelisa izinto ezinetyhefu.Ezi zinto zitshabalalisa iiseli ezibomvu zegazi kwaye zibangela ukonzakala kwezintso.

IHemolytic-uremic syndrome (HUS) ihlala isenzeka emva kosulelo lwesisu E coli ibhaktheriyaEscherichia coli I-O157: H7). Nangona kunjalo, le meko ikwanxulunyaniswe nezinye izifo zesisu, kubandakanya i-shigella kunye ne-salmonella. Kuye kwadibaniswa nokusuleleka kwintsholongwane.

I-HUS ixhaphake kakhulu kubantwana. Ngoyena nobangela uqhelekileyo wokungaphumeleli kwezintso ebantwaneni. Ukuqhambuka okukhulu kuye kwayanyaniswa nenyama ye hamburger engaphekwanga engcolileyo E coli.

E coli ingadluliselwa nge:

• Nxibelelana nomntu omnye uye komnye
• Ukutya ukutya okungaphekwanga, njengeemveliso zobisi okanye inyama yenkomo

I-STEC-HUS ayifanelanga ukubhideka ne-atypical HUS (aHUS) engahambelaniyo nosulelo. Iyafana nesinye isifo esibizwa ngokuba yi-thrombotic thrombocytopenic purpura (TTP).

I-STEC-HUS ihlala iqala ngokugabha kunye norhudo, olunokuba ligazi. Kwisithuba seveki, umntu unokuba buthathaka kwaye abe nomsindo. Abantu abakule meko banokuchama ngaphantsi kwesiqhelo. Iziphumo zomchamo zinokuphantse ziyeke.

Ukutshatyalaliswa kweeseli ezibomvu kukhokelela kwiimpawu ze-anemia.

Iimpawu zokuqala:

• Igazi kwizitulo
• Ukucaphuka
• Ifiva
• Ukuhamba
• Ukugabha kunye norhudo
• Ubuthathaka

Iimpawu kamva:

• Ukuthuthuzela
• Ukuhla kwengqondo
• Iziphumo eziphantsi zomchamo
• Akukho mveliso yomchamo
• Umtsalane
• Ukuxhuzula - kunqabile
• Irhashalala yolusu ekhangeleka ngathi ngamabala abomvu (petechiae)

Umboneleli wezempilo uya kwenza uvavanyo lomzimba. Oku kungabonisa:

• Ukudumba kwesibindi okanye udakada
• Utshintsho lwenkqubo

Iimvavanyo zaselebhu ziya kubonisa iimpawu ze-hemolytic anemia kunye nokusilela okunamandla kwezintso. Uvavanyo lunokubandakanya:

• Uvavanyo lwe-clotting test (PT kunye ne-PTT)
• Iphaneli yemetabolism ebanzi inokubonisa ukonyuka kwamanqanaba e-BUN kunye ne-creatinine
• Ukubala okupheleleyo kwegazi (i-CBC) kunokubonisa ukwanda kwenani leeseli ezimhlophe kunye nokuhla kokubala kweeseli ebomvu
• Ukubalwa kweplatelet kuhlala kuncitshiswa
• Uhlalutyo lomchamo lunokubonisa igazi kunye neeprotein kumchamo
• Uvavanyo lweprotein yomchamo lunokubonisa isixa seprotein kumchamo

Olunye uvavanyo:

• Isitulo senkcubeko sinokulunga kuhlobo oluthile lwe E coli iibhaktheriya okanye ezinye iibhaktheriya
• Colonoscopy
• I-biopsy yezintso (kwiimeko ezinqabileyo)

Unyango lunokubandakanya:

• Uxilongo
• Amayeza, anjengee-corticosteroids
• Ulawulo lwamanzi kunye neelectrolyte
• Ukutshintshelwa kweeseli ezibomvu zegazi kunye neeplatelets

Esi sisifo esibi kubantwana nakubantu abadala, kwaye kunokubangela ukufa. Ngonyango olululo, ngaphezulu kwesiqingatha sabantu siya kuphila. Isiphumo silunge ngakumbi kubantwana kunabantu abadala.

Iingxaki zinokubandakanya:

• Iingxaki zokunqanda igazi
• I-anemia yeHemolytic
• Ukungaphumeleli kwezintso
• Uxinzelelo lwexinzelelo olukhokelela ekuthinjweni, ukuba nochuku, kunye nezinye iingxaki zenkqubo yeemvakalelo
• Zimbalwa kakhulu iiplatelets (thrombocytopenia)
• IUremia

Tsalela umnikezeli wakho ukuba uphuhlisa iimpawu ze-HUS. Iimpawu ezingxamisekileyo zibandakanya:

• Igazi esitulweni
• Akukho kuchama
• Ukunciphisa ukunciphisa (ukuqonda)

Fowunela umnikezeli wakho ukuba ubenesiqendu se-HUS kwaye ukuphuma komchamo wakho kuyancipha, okanye uphuhlisa ezinye iimpawu.

Unokuthintela isizathu esaziwayo, E coli, Ngokupheka ihambhega kunye nezinye inyama kakuhle. Kuya kufuneka uphephe ukunxibelelana namanzi angahlambulukanga kwaye ulandele iindlela ezifanelekileyo zokuhlamba izandla.

HUS; STEC-HUS; Isifo sehemolytic-uremic

• Inkqubo yomchamo wamadoda

UAlexander T, uLicht C, uSmoyer WE, uRosenblum ND. Izifo zezintso kunye nomchamo ongaphezulu womchamo ebantwaneni. Ku: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, ii-eds. Brenner kunye noMphathi weZintso. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2020: isahluko: 72.

UMele C, uNoris M, uRemuzzi G.Ihemolytic uremic syndrome. Ku: Ronco C, Bellomo R, Kellum JA, Ricci Z, ii-eds. Unonophelo olubalulekileyo lweNephrology. Ngomhla wesi-3. IPhiladelphia, PA: Elsevier; I-2019: isahluko 50.

USchneidewend R, uEpperla N, uFriedman KD. I-Thrombotic thrombocytopenic purpura kunye ne-hemolytic uremic syndromes. Ku: Hoffman R, Benz EJ, Silberstein LE, et al, ii-eds. I-Hematology: Imigaqo esisiseko kunye nokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2018: isahluko 134.