Isifo Sokuzenzekelayo
Idiopathic thrombocytopenic purpura (ITP), ebizwa ngokuba yi-immune thrombocytopenic purpura, yimeko apho umzimba ungenawo amaplatele ngokwaneleyo. Iiplatelet ziseli zegazi eziyekelela ukunqanda ukuphuma kwegazi ngokubambisana kunye nokwenza amacwecwe anqumle ukutywa okanye ukuphulwa okuncinci.
"Idiopathic" (id-ee-o-PATH-ick) ithetha ukuba isizathu sesifo asiyazi.
"I-Thrombocytopenic" (i-throm-bo-site-o-PEE-nick) ithetha iiplatelets eziphantsi kwegazi.
"I-Purpura" (i-PURR-purr-ah) ithetha ukuba umntu unobungozi obukhulu.
Abaphandi bakholelwa ukuba i-ITP iyingozi yokuzimela. Umzimba ngokuqhelekileyo wenza ama-antibodies alwa nosuleleko, kodwa kwi-ITP ezi hlaselo ze-antibodies zihlasela kwaye zichithe iiplatelets eziphilileyo zomzimba. Yintoni eyenza oku kungaziwa. I-ITP ivela kubantu abangama-50 ukuya ku-150 kwisigidi ngamnye ngonyaka. Phantse isiqingatha sabantu abachaphazelekayo ngabantwana. I-ITP inokuchaphazela ama-2 ukuya kuma-3 amaxesha amaninzi ngaphezu kwamadoda.
Iintlobo
Kukho iintlobo ezimbini ze-ITP.
- I-ITP eyiyo yinkqubo yesikhashana okanye yexesha elifutshane le-ITP. Ngokuqhelekileyo ihlala iinyanga ezingaphantsi kwe-6. Uhlobo oluqhelekileyo lwe-ITP kwaye luvela ikakhulu kubantwana, abafana kunye namantombazana, ngokuqhelekileyo phakathi kweminyaka emi-2 ne-4 ubudala. Ngokuqhelekileyo kwenzeka emva kokuba umntwana esusulelekileyo okanye ugula ngentsholongwane.
- I-ITP engapheli ihlala ixesha elide, ngokuqhelekileyo ibangela iimpawu kwiinyanga ezili-6 okanye ngaphezulu. Inokuchaphazela kakhulu abantu abadala, kodwa ngamanye amaxesha abantwana abaselula okanye abantwana banokuphuhlisa.
Iimpawu
Iimpawu ze-ITP zingaquka:
- Ukululaza okanye ukugqithisa ngokweqile; izibhamu zingenzeka ngenxa yesizathu esicacileyo (purpura)
- Amachashaza amancinci-ebomvu kwiplastiki (petechiae), ngokukodwa kwimilenze engaphantsi, ebangelwa ukuphuma kwegazi phantsi kwesikhumba
- Ukunyuka okuthatha ixesha elide ukuyeka ukuphuma kwegazi
- Ukuhluma okanye ukuphuma kwizinsini
- Igazi emzimbeni okanye ekuhambeni kwamathumbu
- Abasetyhini banokuba negazi elinzima lokuphuma kwindoda
Abanye abantu abane-ITP abanobuchule banokuba neempawu ezimbalwa okanye ezingekho.
Ukuxilongwa
Ukuxilongwa kwe-ITP kwenziwa ngokuhlaziywa kwimbali yonyango, ukuhlolwa ngokomzimba kunye nokuhlolwa kwegazi. Ngethuba lembali kunye novavanyo lomzimba, ugqirha uya kukhangela iimpawu zokuphaphaza kunye nayiphi na iimeko ezingabangela inani eliphantsi leeplatelet egazini. Uvavanyo lwegazi luquka inani elipheleleyo legazi (iCBC), eline-ITP eziza kubonisa inani elincinci leeplatelets, kunye ne-blood smear, apho isampuli yegazi ibukelwa phantsi kwe-microscope.
Ngaba i-ITP Hereditary?
Abaphandi abazange bagqibe isizathu sokuba i-ITP ibe yindlalifa njengoko eso sifo asiqhelekanga kwiintsapho.
Unyango
Uninzi lwabantwana abane-acute uhlobo lwe-ITP luyabuya ngokupheleleyo kwi-ITP malunga neenyanga ezintandathu ngaphandle kokunyanga. Abantu abadala abane-ITP abancinci bangasayi kufuna unyango. Unyango lwe-ITP ujolise ekunyuseni inani leeplatelets egazini. Kubantu abadala kunye nabantwana abafuna unyango, i-corticosteroid efana ne-Prednisone idlalwa iiveki okanye iinyanga eziliqela ukunciphisa ukuvuvukala emzimbeni. Olunye unyango olunokunceda ukwandisa inani leeplatelet li-immune globulin.
Ngokuqhelekileyo unikezwa nge-intravenously (ngokusebenzisa inaliti emthanjeni).
Xa izigulane zingaphenduli kumachiza, ityha ingasuswa igqirha emzimbeni. Kwi-ITP, ipenki icingelwa ukuba iyindawo ephawulekayo yokuvelisa i-antibody kunye nokutshatyalaliswa kweplatelet. Nangona kunjalo, ukususa ipeni kungenza umntu abe ngowomngcipheko wokufumana iintlobo ezithile zezifo.
Abanye abantu abane-ITP abanegazi elininzi abanokufumana ukumpontshelwa kweplatelet. Iiplatelet zinikelo ezivela kwiibhanki zegazi zifakwe kwigazi lomntu ukwenyusa okwethutyana inani lamaplatelet emzimbeni.
Iyeza elibizwa ngokuba yiRituxan (rituximab) lizama ukuzama ukunyango njengengonyango ye-ITP engapheliyo.
Kwakhona kunikezwe ngaphakathi. Amanye amachiza amaninzi ayazama. I-Platelet Disorder Support Association igcina uluhlu lweemvavanyo zonyango lwe-ITP eziqhubekayo.
Imithombo:
Ukuvavanya umntwana ngePurpura. I-American Academy yeeNgcali zoLuntu. www.aafp.org.
Yintoni i-Immune Thrombocytopenia. I-Heart Heart Lung ne-Blood Institute.
B-cell cell Depletion (anti-CD20.