Ukuphononongwa kweMpawu, ukuxilongwa kunye noTyango
Inkcazo
I-immune thrombocytopenia (i-ITP), ebizwa ngokuba yi-idiopathic thrombocytopenic purpura, yimeko apho i-immune system yakho ihlasela kwaye ichithe iiplatelet zakho ezibangela ukubala kweplatelet ephantsi ( thrombocytopenia ). Iiplatelet ziyimfuneko zokugubha igazi kwaye ukuba ungenayo ngokwaneleyo, unokufumana igazi.
Iimpawu ze-ITP
Iimpawu ze-ITP zihlobene nomngcipheko okhulayo wokuphuma kwegazi ngenxa yobuninzi bakho beplatelet count.
Nangona kunjalo, abantu abaninzi abane-ITP abanakho iimpawu.
Iimbopho
Ukuhlanjululwa kwizinsini
Igazi kwi-urine okanye kwisitulo
Ukuphuma kwexesha lokuya esikhathini esibizwa ngokuba yi- menorrhagia
I-Petechiae - amacotshi amancinci amancinci angathi afane nokugqithisa kodwa ngokwenene inani elincinci lokuphuma phantsi kwesikhumba
Ukuqhekeka lula - izivalo zingase zibe zikhulu kwaye zikwazi ukuvalelwa phantsi kwesikhumba
I-blood blisters ngaphakathi ngaphakathi emlonyeni obizwa ngokuba yi-purpura
Izizathu ze-ITP
Ngokuqhelekileyo, isibalo sakho seplatelet sehla kwi-ITP ngenxa yokuba umzimba wakho wenza ama-antibodies anamathele kwiiplatelets aze abonakalise ukutshatyalaliswa. Xa ezi iplatelet zigeleza ngedeni (isitho esiswini esisenza igazi legazi), siyaziqonda ezi zixhobo kwaye zichithe iiplatelets. Kwakhona ukuveliswa kweeplatelet kunokuncitshiswa. I-ITP iyaqhubeka emva kwesiganeko esishukumisayo, ngamanye amaxesha ugqirha wakho angenako ukuqonda ukuba yintoni esi siganeko.
Iintsholongwane: Kubantwana, i-ITP idla ngokubangelwa yi-HIV. Ukusuleleka kwintsholongwane kubakho rhoqo emva kweeveki ezimbalwa ngaphambi kokuphuhliswa kwe-ITP. Nangona i-immune system yenza izixhobo zokulwa neengculaza zilwa nokusuleleka kwintsholongwane yentsholongwane leyo yenze ngenye indlela iindiza ezithintela kwiiplatelets.
Ukugonywa: I- ITP inxulumene nokulawulwa kwe-MMR (isifo sokugonywa kwemasisi, imasps, rubella). Ngokuqhelekileyo kubakho kwiiveki ezi-6 zokufumana isitofu. Kubalulekile ukuqaphela ukuba esi sisiganeko esingavumelekanga esinama-2.6 amatyala kuwo onke ama-MMR angama-100,000. Olu mngcipheko luyingcipheko kunomngcipheko wokuphuhlisa i-ITP ukuba unesifo se-measles okanye i-rubella. Ukuphuma kwegazi kunqabile kula maxesha kwaye abantu abangaphezu kwama-90% baya kuba nesisombululo se-ITP kwisithuba seenyanga ezintandathu.
Izifo ezizenzekelayo: I- ITP ithathwa njengengxaki yokuzimela kunye kwaye idibene nezinye izifo ezizimeleyo ezifana ne-lupus ne-rheumatoid arthritis. I-ITP inokuthi ingeniso yokuqala ngenye yezi meko zonyango.
Ukuxilongwa kwe-ITP
Ngokufanayo nezinye izifo zegazi ezifana ne- anemia kunye ne- neutropenia , i-ITP iboniswe kwisibalo esigcwele segazi (CBC). Akukho vavanyo lwe-diagnostic ye-ITP. Kuxilongwa ukukhutshwa, oku kuthetha ezinye izizathu eziye zagqitywa ngaphandle. Ngokubanzi, kuphela inani leplatelet linciphile kwi-ITP; inani le-white cell and hemoglobin ziqhelekileyo. Umboneleli wakho wempilo unokuba neeplatelet zihlolwe phantsi kwe-microscope (ebizwa ngokuba yi-blood pipeline smear) ukuqinisekisa ukuba iiplatelet zinciphisa kwinombolo kodwa zibonakala ziqhelekileyo. Phakathi kwenkcitho, unokuba nezinye iimvavanyo ukulawula umhlaza okanye ezinye izizathu zokubala kweplatelet ephantsi, kodwa oku akusoloko kufuneka. Ukuba i-ITP yakho icingelwa ukuba isesibini kwisifo esizimele, kunokufuneka uhlolwe ngokukodwa oku.
Unyango lwe-ITP
Njengamanje, unyango lwe-ITP luxhomekeke ekubeni khona kweempawu eziphaphakileyo kunokuba kubekho i-platelet count count. Injongo yonyango ukuyeka ukuphuma kwegazi okanye ukuzisa inani leplatelet ukuya kwindawo "ekhuselekileyo".
Nangona ngeyona nto ingekho "unyango", abantu abane-ITP kufuneka baphephe ukuthatha i-aspirin okanye imithi eline-ibuprofen njengoko la mayeza anciphisa umsebenzi weeplatelets.
Ukuqwalaselwa: Ukuba awukho na iimpawu eziphaphayo ngoku, ugqirha wakho angakhetha ukukubukela ngaphandle kokunika unyango.
I-Steroids: I-Steroids efana ne-methylprednisolone okanye i-prednisone yimiyeza eqhelekileyo esetyenziswa ukuphatha i-ITP emhlabeni jikelele. I-Steroids inciphisa ukutshatyalaliswa kweeplatelet kwipeni. I-Steroids iphumelela kakhulu kodwa ingathatha ngaphezu kweveki ukwenzela ukunyusa inani leplatelet yakho.
I-IVIG: I-immune globulin (i-IVIG) yokuxhatshazwa yinto eqhelekileyo yonyango lwe-LTP. Ngokuqhelekileyo isetyenziswe kwizigulane ezinegazi elifuna ukunyuka ngokukhawuleza kwi-platelet count. Ilawulwa njenge-intravenous (IV) ukunyuka kweeyure eziliqela.
WinRho: WinRho yimithi ye-IV engasetyenziswa ukunyusa inani leplatelet kubantu abaneentlobo ezithile zegazi. Ingumngcipheko okhawulezayo kune-IVIG.
Ukuxilongwa kwePlatelet: Ukuxilongwa kweplatelet akusoloko kunceda kubantu abane-ITP kodwa kunokusetyenziswa kwiimeko ezithile ezifana nokuba kufuneka usebenze.
Ukuba i-ITP yakho iqhubeka kwaye ayiphenduli unyango lokuqala, unogqirha ungacebisa ezinye iindlela zonyango ezifana:
I-Splenectomy : Kwi-ITP iiplatelets zonakaliswa ngepeni. Ngokususa ipeni, ukulindela ubomi kweeplatelets kunokunyuswa. Izinzuzo kunye neengozi kufuneka zilinganiswe ngaphambi kokuthatha isigqibo sokususa ipeni.
Rituximab : I- Rituximab yipilisi ebizwa ngokuba yi-antioclonal antibody. La mayeza anceda ukutshabalalisa iiseli ezimhlophe zegazi ezivelisa i-antibodies malunga neeplatelet, ezibizwa ngokuba yi-B. Ithemba kukuba xa umzimba wakho uvelisa iiseli ezitsha ze-B, abayi kuphinda benze i-antibody ngeplatelet.
I-thrombopoietin agonists: Ezinye zezokwelapha ezintsha zi-thrombopoietin (TPO). Ezi zonyango zi-eltrombopag (ngomlomo) okanye i-romiplostim (ngaphantsi); zivuselela umongo wakho weethambo ukwenza iiplatelet ezingaphezulu.
Ukwahlukana kwabantwana nakubantu abadala
Kubalulekile ukuba uqaphele ukuba imbali yendalo ye-ITP ihlala ihluke kubantwana kunye nabantu abadala. Ngaphezu kwe-80% yabantwana abaxilongwa nge-ITP baya kugqiba ngokupheleleyo. I-Adolescents kunye nabantu abadala banakho amathuba okuhlakulela i-ITP engapheliyo ibe yimeko yempilo yonyango engadlulanga unyango.
> Umthombo:
> CE Neunert, DL Yee. Iingxaki zePlatelet. Ku: CD Rudolph, AM Rudolph, GE Lister, i-LR yokuqala kunye ne-AA Gershon eds. I-Rudolph's Pediatrics . Wama-22. ENew York: iMicrora Hill Hill, ngo-2011.