Isifo samanzi-Friderichsen syndrome

Isifo samanzi i-Waterhouse-Friderichsen syndrome (WFS) liqela leempawu ezibangelwa kukusilela kwamadlala e-adrenal ukuba asebenze ngesiqhelo njengesiphumo sokuphuma kwegazi kwincindi.

Amadlala ngamadlala amabini amile okonxantathu. Idlala elinye libekwe ngaphezulu kwentso nganye. Amadlala adrenal avelisa kwaye akhulule iihormoni ezahlukileyo ekufuneka umzimba usebenze ngokwesiqhelo. Amadlala adrenal anokuchaphazeleka kwizifo ezininzi, ezinje ngezifo ezinje nge-WFS.

I-WFS ibangelwa lusulelo olomeleleyo nge-meningococcus bacteria okanye ezinye iibacteria, ezinje:

• Iqela le-streptococcus
• Pseudomonas aeruginosa
• IStreptococcus pneumoniae
• IStaphylococcus aureus

Iimpawu zenzeka ngesiquphe. Kungenxa yebacteria ekhulayo (ephindaphindayo) ngaphakathi komzimba. Iimpawu zibandakanya:

• Umkhuhlane kunye nokubanda
• Intlungu edibeneyo neyomzimba
• Intloko ebuhlungu
• Ukuhlanza

Usulelo lwebacteria lubangela ukopha emzimbeni, nto leyo ebangela:

• Ukukhawuleza komzimba
• Kusasazwa i-intravascular coagulation apho amahlwili egazi amancinci anqumamisa ukunikezelwa kwegazi kumalungu
• Ukutshatyalaliswa kwe-Septic

Ukopha kwiincindi zamadlala kubangela ingxaki ye-adrenal, apho iihomoni ezaneleyo ze-adrenal aziveliswa. Oku kukhokelela kwiimpawu ezinje:

• Ukuba nesiyezi, ubuthathaka
• Uxinzelelo lwegazi oluphantsi kakhulu
• Isantya sentliziyo esikhawulezayo kakhulu
• Ukudideka okanye isiqaqa

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu zomntu.

Kuya kwenziwa uvavanyo lwegazi ukuqinisekisa usulelo lwebacteria. Uvavanyo lunokubandakanya:

• Inkcubeko yegazi
• Gcwalisa ubalo lwegazi ngokwahluka
• Izifundo zokunqanda igazi

Ukuba umboneleli ukrokrela ukuba usulelo lubangelwa yi-meningococcus bacteria, ezinye iimvavanyo ezinokuthi zenziwe zibandakanya:

• Ukugqobhoza iLumbar ukufumana isampulu yolwelo lomqolo kwinkcubeko
• Ulusu lwe-biopsy kunye nebala legram
• Uhlalutyo lomchamo

Uvavanyo olunokuyalelwa ukuba luncede ekuchongeni intlekele enkulu ye-adrenal ibandakanya:

• I-ACTH (cosyntropin) yovavanyo lokukhuthaza
• Uvavanyo lwegazi lweCortisol
• Iswekile yegazi
• Uvavanyo lwegazi lwePotassium
• Uvavanyo lwegazi
• Uvavanyo lwe-pH yegazi

Amayeza okubulala iintsholongwane aqala kwangoko ukunyanga usulelo lwebacteria. Amayeza eglucocorticoid aya kunikwa ukunyanga ukungoneliseki kwe-adrenal gland. Unyango oluxhasayo luya kufuneka kwezinye iimpawu.

I-WFS iyabulala ngaphandle kokuba unyango losulelo lwebacteria luqale kwangoko kwaye kunikwa iziyobisi ngeglucocorticoid.

Ukuthintela i-WFS ebangelwa yi-meningococcal bacteria, iyeza lokugonya liyafumaneka.

Imingingococcemia yeFulminant-Isifo samanzi-Friderichsen syndrome; I-sepsis ye-menminococcal ye-Fulminant-Isifo samanzi-Friderichsen syndrome; I-adrenalitis eyophayo

• Izilonda ze-Meningococcal ngasemva
• Ukukhutshwa kwe-adrenal gland secretion

I-Stephens DS. Iimpawu zeNeisseria. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. Mandell, Douglas, kunye neBennett's Principles and Practice of Infectious Diseases. Umhla we-9. IPhiladelphia, PA: Elsevier Saunders; 2020: isahluko 211.

Ixabiso elitsha le-JDC, i-Auchus RJ. I-adrenal cortex. Ku: UMelmed S, uAuchus RJ, uGoldfine AB, uKoenig RJ, uRosen CJ, ii-eds. Incwadi ebhaliweyo kaWilliam ye-Endocrinology. Umhla we-14. IPhiladelphia, PA: Elsevier; 2020: isahl. 15.