I-anemia ye-immune hemolytic

I-anemia yimeko apho umzimba ungenayo iiseli ezibomvu zegazi ezaneleyo. Iiseli ezibomvu zegazi zibonelela ngeoksijini kwizicubu zomzimba.

Iiseli ezibomvu zegazi zihlala malunga neentsuku ezili-120 ngaphambi kokuba umzimba uzilahle. Kwi-hemolytic anemia, iiseli ezibomvu zegazi zitshatyalaliswa kwangoko kunesiqhelo.

I-immune hemolytic anemia yenzeka xa iiseli zomzimba zichasene neeseli ezibomvu zomzimba kwaye ziyitshabalalise. Oku kwenzeka ngenxa yokuba amajoni omzimba ngokungafanelekanga azithathela ingqalelo ezi seli zegazi njengezangaphandle.

Izizathu ezinokubakho zibandakanya:

• Ezinye iikhemikhali, iziyobisi, kunye neetyhefu
• Usulelo
• Ukuhanjiswa kwegazi kulowo unikeleyo kudidi lwegazi olungadibaniyo
• Eminye imihlaza

Xa ii-antibodies zenza ngokuchasene neeseli ezibomvu zegazi ngaphandle kwesizathu, imeko ibizwa ngokuba yi-idiopathic autoimmune hemolytic anemia.

Amachiza omzimba angabangelwa:

• Ukunyanga kwesinye isifo
• Utofelo-gazi oludlulileyo
• Ukukhulelwa (ukuba uhlobo lwegazi lomntwana lwahlukile kunolomama)

Izinto ezinobungozi zihambelana nezizathu.

Awunakuba neempawu ukuba i-anemia ithambile. Ukuba ingxaki ikhula kancinci, iimpawu ezinokuthi zenzeke kuqala zibandakanya:

• Ukuziva ubuthathaka okanye udiniwe rhoqo kunesiqhelo, okanye ngokwenza umthambo
• Intloko ebuhlungu
• Iingxaki zokugxila okanye zokucinga

Ukuba i-anemia iya isiba mandundu, iimpawu zinokubandakanya:

• Ubukhaphukhaphu xa uphakama
• Umbala wesikhumba omdaka (pallor)
• Ukuqhawukelwa ngumphefumlo
• Ulwimi olubi

Unokufuna ezi mvavanyo zilandelayo:

• Ukubala kwe-reticulocyte ngokupheleleyo
• Uvavanyo oluthe ngqo okanye olungathanga ngqo lweCombombs
• IHemoglobin kumchamo
• I-LDH (inqanaba lale enzyme lenyuka ngenxa yomonakalo wethishu)
• Inani elibomvu leeseli zegazi (i-RBC), i-hemoglobin, kunye nehemmatocrit
• Inqanaba leSerum bilirubin
• I-hemoglobin yasimahla yeSerum
• Iselfowuni haptoglobin
• Uvavanyo lweDonath-Landsteiner
• Ii-agglutinins ezibandayo
• Ihemoglobin yasimahla kwi-serum okanye kumchamo
• IHemosiderin kumchamo
• Ubalo lweplatelet
• Iiproteni electrophoresis - serum
• IPyruvate kinase
• Inqanaba le-haptoglobin yeserum
• Umchamo kunye nomchamo urobilinogen

Unyango lokuqala olulingekileyo luhlala lunyango lwe-steroid, njenge-prednisone. Ukuba amayeza e-steroid ayiphuculi le meko, unyango nge-intravenous immunoglobulin (IVIG) okanye ukususwa kwepeni (splenectomy) kunokuqwalaselwa.

Unokufumana unyango lokucinezela amajoni akho omzimba ukuba awuphenduli kwi-steroids. Iziyobisi ezinje nge-azathioprine (Imuran), cyclophosphamide (Cytoxan), kunye ne-rituximab (Rituxan) zisetyenzisiwe.

Utofelo-gazi lwenziwa ngononophelo, kuba igazi linokungahambelani kwaye kunokubangela ukutshabalalisa iiseli ezibomvu.

Esi sifo sinokuqala ngokukhawuleza kwaye sinzulu kakhulu, okanye sinokuhlala sinobulali kwaye singadingi unyango olukhethekileyo.

Uninzi lwabantu, i-steroids okanye i-splenectomy inokulawula ngokupheleleyo okanye ngokungaphelelanga i-anemia.

Ukuqaqanjelwa kwegazi kakhulu kunqabile kukhokelela ekufeni. Usulelo olunzima lunokwenzeka njengengxaki yonyango nge-steroids, amanye amayeza acinezela amajoni omzimba, okanye i-splenectomy. Olu nyango luphazamisa ukubanakho komzimba ukulwa usulelo.

Fowunela umboneleli wakho wezempilo ukuba unokudinwa okungachazwanga okanye iintlungu zesifuba, okanye iimpawu zosulelo.

Ukuvavanywa kwee-antibodies kwigazi elinikelwayo kwaye kumamkeli kunokuthintela i-hemolytic anemia enxulumene notofelo-gazi.

Anemia - hemolytic omzimba; I-anemia ye-hemolytic autoimmune (AIHA)

• Iintsholongwane

UMichel M. Ukuzenzekelayo kunye ne-intravascular hemolytic anemias. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahl. 151.

UMichel M, uJäger U.I-anemia ye-hemolytic ezenzekelayo. 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 46.