Inkcazo
I-glucose 6 I-Phosphate Dehydrogenase (G6PD) isweleko yintlupheko ye-enzyme ekhoyo kwihlabathi. Phantse abantu abayizigidi ezingama-400 abachaphazelekayo emhlabeni jikelele. Kukho ukuhluka okukhulu kwinqanaba elisekelwe ekuguqulweni kwelifa.
I-G6PD iyi-enzyme efunyenwe kwiseli elibomvu legazi elifunekayo ukunika amandla kwiseli. Ngaphandle kwalo mandla, iseli elibomvu legazi libhujiswa ngumzimba (i-hemolysis) ekhokelela ekubeni ne- anemia kunye ne-jaundice (ukuphuzila kwesikhumba).
Ngubani Osemngciphekweni we-G6PD?
Imfuza ye-G6PD ifumaneka kwi-X ye-chromosome eyenza abesilisa banokungabikho kwintlupheko ye-G6PD (i-X-linked disorder). Ukusilela kwe-G6PD kukhusela abantu ekusulelekeni kwi-malariya ngoko kubonakala ngokuqhelekileyo kwiindawo ezinokutheleleka kwezinga le-malariya ephezulu njenge-Afrika, ummandla waseMeditera kunye ne-Asia. EUnited States, i-10% yabantu base-Afrika baseMelika banesifo se-G6PD.
Ziziphi Iimpawu?
Iimpawu zixhomekeke kuloluphi utshintsho oluthatha ilifa. Abanye abantu abanakuze bafumaneke ukuba akukho mpawu ekhoyo. Ezinye izigulane ezinokukhubazeka kwe-G6PD zinempawu kuphela xa zichazwe kumayeza athile okanye ukutya (jonga uluhlu olungezantsi). Abanye abantu banokuthi bafunyanwe njengeintsana emva kokufumana i-jaundice enzima (ebizwa ngokuba yi-hyperbilirubinemia). Kuzo zi gulane kunye nalabo abaneendlela ezinzima kakhulu ze-G6PD ezingenayo i-hemolysis engapheliyo, iimpawu ziquka:
- Umbala wePallor okanye umbala obalala
- Iqondo lentliziyo ekhawulezayo
- Ukukhathala okanye ukhathala
- Uziva utyhafile okanye utyhefu
- Ukuqhwala kwesikhumba (i-jaundice) okanye amehlo (i-icterus ye-scleral)
- Umchamo omnyama
Ulwaphulo lwe-G6PD lubonwa njani?
Ukufumanisa ukusilela kwe-G6PD kunokukhohlisa. Okokuqala, ugqirha kufuneka ugculele ukuba unesifo se-hemolytic anemia (ukuchithwa kwamaseli obomvu). Oku kuvame ukuqinisekiswa ngokubala okupheleleyo kwegazi kunye nombolo ye-reticulocyte.
I-Reticulocyte iisetyini zegazi ezibomvu ezithunyelwe kwi-bone lomnxeba ekuphenduleni i-anemia. Inemia ye-anemia ene-high reticulocyte count ihambelana ne-hemolytic anemia. Ezinye iilabhu zingabandakanya ukubala kwe-bilirubin okuza kuphakanyiswa. I-Bilirubiin ikhutshwa kwi-cell ebomvu yegazi xa idilizwe kwaye ibangela i-jaundice ngexesha leengxaki ze-hemolytic.
Kwinkqubo yokumisela ukuxilongwa, ugqirha wakho uya kufuna ukulawula i- hemolytic anemia (AIHA). Uvavanyo oluchasene ne-globulin test (olubizwa ngokuba luvavanyo lweCoombs ngqo) luvavanya ukuba kukho iindiza eziza kubomvu iiseli ezibomvu ezibangela ukuba zihlaselwe ngumzimba wakho wokuzivikela. Njengamaxesha amaninzi e-anemia ye-hemolytic, i-blood smear ye-peripheral (i-microscope slide yegazi) inceda gqitha. Kwi-G6PD ukusilela, iiseli zokuluma kunye neeseli ze-blister ziqhelekile. Ezi zibangelwa yiinguqu ezenzeka kwi-cell cell ebomvu njengoko libhujiswa.
Ukuba ukulahleka kwe-G6PD kukhunjulwa, inqanaba le-G6PD lingasuswa. Iqondo eliphantsi leG6PD lihambelana nokusilela kwe-G6PD. Ngelishwa, phakathi kwenkathazo enkulu ye-hemolytic inqanaba eliqhelekileyo le-G6PD aliyikulawula ukusilela. I-reticulocytes ezininzi ezikhoyo ngexesha lobunzima be-hemolytic zinamanqanaba aqhelekileyo e-G6PD obangela ukungalunganga.
Ukuba u krokrelwa kakhulu, uvavanyo kufuneka luphindwe xa isigulane sisesimo esisezantsi.
G6PD ithathwa njani?
Gwema amayeza okanye ukutya okubangela i-hemolytic (i-red red cells). Ezinye zezi zidweliswe ngezantsi.
- Iibhontshisi zeFava (ezibizwa ngokuba ziibhontshisi ezibanzi)
- Ibhola yeebhola (okanye ezinye iimveliso ezine-naphthalene)
- I-Sulfa antibiotics njengeBactrim / Septra, i-sulfadiazine
- I-quinolone antibiotics njenge-ciprofloxacin, i-levofloxacin
- Nitrofurantoin (i-antibiotic)
- Ukulwa neyeza-malariya njenge-primaquine
- I-Methylene eluhlaza
- Imithi ye-TB njenge-dapsone kunye ne-sulfoxone
- Unyango lweyeza unyango olunjenge doxorubicin okanye i-rasburicase
- Phenazopyridine
Ukuxilongwa kwegazi kusetyenziswa xa i-anemia iyingozi kwaye isigulane sisifo. Ngethamsanqa, ezininzi izigulane azifuneki ukuxilongwa.